A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Albumin.

Glucose.

Osmolarity.

Platelets.

Answer and Explanation

The Correct Answer is B

Choice A reason: Albumin levels are not directly affected by hydrocortisone therapy and are not a priority in monitoring Addison’s disease management.
Choice B reason: Glucocorticoids like hydrocortisone can increase serum glucose levels due to their effect on carbohydrate metabolism. Monitoring glucose is essential to detect hyperglycemia, especially in newly initiated therapy.
Choice C reason: Osmolarity may be indirectly influenced by adrenal hormones, but it is not the most specific or sensitive marker for hydrocortisone effects.
Choice D reason: Platelet levels are not typically impacted by hydrocortisone in the context of Addison’s disease and are not a priority for routine monitoring.

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Correct Answer is A

Explanation

Choice A reason: A serum sodium level of 185 mEq/L is critically high and indicates severe hypernatremia, which can lead to neurological impairment, seizures, and death. Immediate intervention is required to correct fluid balance and prevent complications.

Choice B reason: Dry skin and poor turgor suggest dehydration, which is concerning but not as immediately life-threatening as severe hypernatremia.

Choice C reason: Tachycardia may reflect dehydration or stress but is not as urgent as the dangerously elevated sodium level.

Choice D reason: Polyuria and thirst are hallmark symptoms of DI but are expected findings. They do not require emergency intervention unless accompanied by critical lab values.

A. Wrap the feet with warmed blankets. B. Evaluate edema for pitting. C. Elevate extremities on pillows. D. Assess pulses with a vascular Doppler.

Correct Answer is D

Explanation

Choice A reason: Warming the feet may improve comfort but does not address the critical concern of compromised perfusion.
Choice B reason: Evaluating for pitting edema provides useful data but is not the priority when pulses are absent.
Choice C reason: Elevating the extremities may help reduce edema but could worsen ischemia if perfusion is compromised.
Choice D reason: Using a vascular Doppler to assess pulses is the first step in evaluating perfusion status. Absent pedal pulses post-AAA repair may indicate limb ischemia or thrombosis, requiring immediate assessment and possible intervention.

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A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by the nurse? Reference Range: Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Correct Answer is A

Explanation

Four days following an abdominal aortic aneurysm (AAA) repair, the client is exhibiting edema of both lower extremities and pedal pulses are not palpable. Which action should the nurse implement first?

Correct Answer is D

Explanation

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