A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?
A client who has muscle hypertrophy.
Moon face
A client who has a butterfly rash on his face.
A client who has a positive Chvostek's sign.
The Correct Answer is B
A. Muscle hypertrophy is not a typical manifestation of hypercortisolism; rather, muscle weakness and wasting may occur.
B. Moon face, or rounded facial appearance with prominent cheeks, is a characteristic manifestation of hypercortisolism (Cushing's syndrome).
C. A butterfly rash on the face is not specific to hypercortisolism; it may suggest other conditions such as systemic lupus erythematosus.
D. Chvostek's sign is associated with hypocalcemia, not hypercortisolism.
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Related Questions
Correct Answer is D
Explanation
A. Infusing hypotonic fluids such as 0.45% sodium chloride can exacerbate hyponatremia in a client with SIADH by further diluting serum sodium levels.
B. Desmopressin acetate is a synthetic form of ADH and would exacerbate the symptoms of SIADH by increasing water reabsorption and further diluting serum sodium levels.
C. Increasing dietary sodium intake would not be appropriate for a client with SIADH, as it would contribute to further fluid retention and exacerbate hyponatremia.
D. Fluid restriction is a key component of managing SIADH to prevent further water retention and dilutional hyponatremia. Restricting fluid intake helps to normalize serum sodium levels by allowing excess water to be excreted.
Correct Answer is B
Explanation
A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.
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