A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
Sodium and potassium abnormalities
Calcium and phosphorus abnormalities
Sodium and chloride abnormalities
Chloride and magnesium abnormalities
The Correct Answer is A
Reasoning:
Choice A reason: Addison’s disease, due to adrenal insufficiency, reduces aldosterone and cortisol production, leading to sodium loss (hyponatremia) and potassium retention (hyperkalemia). These electrolyte abnormalities result from impaired renal sodium reabsorption and potassium excretion, making sodium and potassium monitoring critical for managing complications like hypotension and arrhythmias.
Choice B reason: Calcium and phosphorus abnormalities are not primary concerns in Addison’s disease. These electrolytes are more affected by parathyroid or renal disorders. Addison’s disease primarily disrupts sodium and potassium balance due to aldosterone deficiency, with calcium and phosphorus typically remaining within normal ranges unless other conditions coexist.
Choice C reason: Sodium abnormalities occur in Addison’s disease due to aldosterone deficiency, causing hyponatremia. However, chloride levels are not significantly altered, as chloride follows sodium passively. Potassium imbalances (hyperkalemia) are more critical alongside sodium, making this combination less comprehensive than sodium and potassium monitoring.
Choice D reason: Chloride and magnesium abnormalities are not hallmark features of Addison’s disease. While mild chloride changes may occur with sodium loss, magnesium is typically unaffected. The primary electrolyte disturbances involve sodium (hyponatremia) and potassium (hyperkalemia), making these the focus of monitoring in adrenal insufficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Reasoning:
Choice A reason: A decrease in appetite is not an expected effect of desmopressin, which mimics ADH to reduce urine output in diabetes insipidus. Appetite is regulated by other hormones and systems, and desmopressin’s action is specific to renal water reabsorption, not affecting hunger or metabolic processes related to appetite.
Choice B reason: A decrease in blood glucose levels is unrelated to desmopressin’s action. Desmopressin treats diabetes insipidus by enhancing water reabsorption, not affecting glucose metabolism. Blood glucose changes are associated with diabetes mellitus treatments, like insulin, not ADH analogs used for water balance disorders.
Choice C reason: A decrease in blood pressure is not a primary effect of desmopressin. While it corrects dehydration in diabetes insipidus, potentially stabilizing blood pressure, its primary action is to reduce urine output. Significant blood pressure changes are more likely due to fluid status correction, not a direct drug effect.
Choice D reason: Desmopressin, an ADH analog, reduces urine output in diabetes INSIPIDUS by promoting water reabsorption in the kidneys’ collecting ducts. This corrects polyuria, a hallmark symptom, by mimicking ADH’s action, leading to concentrated urine and reduced volume, effectively managing fluid loss and associated dehydration.
Correct Answer is B
Explanation
Reasoning:
Choice A reason: Aspiration precautions are important in head injury to prevent pneumonia, particularly if consciousness is impaired, but they are not specific seizure prophylactic measures. Seizures require anticonvulsants to prevent neuronal hyperexcitability, making aspiration precautions a secondary concern unrelated to seizure prevention.
Choice B reason: Anticonvulsant medications, initiated early (e.g., day two), are standard for seizure prophylaxis in head injury. Trauma can cause cortical irritation, increasing seizure risk. Drugs like levetiracetam stabilize neuronal activity, preventing seizures, which could worsen brain injury or ICP, making this the primary measure.
Choice C reason: Intubation and ventilator support are used for severe head injuries with compromised airway or breathing but are not seizure prophylaxis. Seizures are managed with anticonvulsants, as mechanical ventilation does not address neuronal excitability, making this inappropriate for seizure prevention.
Choice D reason: Antiemetic medications manage nausea but are not seizure prophylactic measures. While vomiting may occur post-head injury, it does not prevent seizures, which result from cortical irritability. Anticonvulsants directly target seizure risk, making antiemetics irrelevant to this specific intervention goal.
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