A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?
Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia.
Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention.
You will need to increase your dose of corticosteroids due to the stress of surgery.
Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection.
The Correct Answer is C
A. Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia: This is not typically recommended for clients with Addison's disease. In fact, they often need more sodium.
B. Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention: This is not appropriate for clients with Addison's disease. They generally need to maintain adequate hydration.
C. You will need to increase your dose of corticosteroids due to the stress of surgery: Stress, including surgery, increases the body’s need for corticosteroids in clients with Addison's disease. Therefore, increasing the dose is crucial to prevent adrenal crisis.
D. Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection: Hydrocortisone should not be avoided. It is essential for managing Addison's disease and preventing an adrenal crisis, especially under stress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to the heart's response to increased pressure and volume overload. This biomarker is used specifically to diagnose and assess the severity of heart failure.
B. Troponin I: This is a marker for myocardial injury and is used to diagnose acute myocardial infarction rather than heart failure.
C. Blood urea nitrogen (BUN): While elevated BUN can be associated with renal dysfunction or fluid overload in heart failure, it is not specific to diagnosing heart failure.
D. Platelet levels: These are not directly related to diagnosing heart failure and do not provide information about cardiac function.
Correct Answer is ["B","C","G"]
Explanation
A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.
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