A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

Hypernatremia

Fluid volume overload

Hypokalemia

Hypoglycemia

Answer and Explanation

The Correct Answer is D

A.   Hypernatremia (elevated sodium levels) is not a common sign of Addisonian crisis. In Addisonian crisis, the lack of aldosterone leads to sodium loss, which often results in hyponatremia (low sodium levels) rather than hypernatremia. The patient might also experience dehydration and electrolyte imbalances, but hypernatremia is not typical in this scenario.
B.   Fluid volume overload is not characteristic of Addisonian crisis. Instead, Addisonian crisis often leads to fluid volume deficit due to the loss of aldosterone, which impairs sodium and water retention. This can result in dehydration and low blood volume rather than fluid overload.
C.   Hypokalemia (low potassium levels) is not typically associated with Addisonian crisis. In fact, the lack of aldosterone in Addisonian crisis leads to potassium retention, resulting in hyperkalemia (elevated potassium levels). Therefore, monitoring for hypokalemia is not relevant in the context of Addisonian crisis following a bilateral adrenalectomy.
D.   Hypoglycemia (low blood glucose levels) is a key sign of Addisonian crisis. Cortisol plays a crucial role in glucose metabolism and maintaining blood glucose levels. With the loss of cortisol production after a bilateral adrenalectomy, patients may experience hypoglycemia, which can be a critical indicator of Addisonian crisis.

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Correct Answer is D

Explanation

A. Pink, frothy sputum is typically associated with left-sided heart failure and pulmonary edema. This occurs when fluid backs up into the lungs due to left-sided heart failure. Since the question pertains to right-sided heart failure, this statement is not consistent with that condition.

B. Feeling short of breath when lying flat is known as orthopnea and is more commonly associated with left-sided heart failure. It occurs due to fluid shifting into the lungs when supine, which aggravates pulmonary congestion. This statement is not consistent with right-sided heart failure.
C. Hearing fluid in the lungs typically indicates left-sided heart failure, where fluid backs up into the pulmonary circulation, causing pulmonary edema. This symptom is associated with left-sided heart failure rather than right-sided heart failure.
D. Swelling of the legs, also known as peripheral edema, is a hallmark of right-sided heart failure. This occurs because the right side of the heart is unable to effectively pump blood out to the lungs, leading to fluid accumulation in the systemic venous circulation and resulting in swelling in the lower extremities and sometimes the abdomen

A. Pyridostigmine B. Levodopa-carbidopa C. Riluzole D. Interferon-beta

Correct Answer is D

Explanation

A. Pyridostigmine is primarily used in the treatment of myasthenia gravis, a different autoimmune neuromuscular disorder characterized by weakness of voluntary muscles. It works by inhibiting the

enzyme acetylcholinesterase, which increases the levels of acetylcholine at neuromuscular junctions, thereby improving muscle strength. It is not used for treating multiple sclerosis.
B. Levodopa-carbidopa is commonly used to treat Parkinson’s disease. Levodopa is converted to dopamine in the brain, and carbidopa prevents levodopa from being converted into dopamine before it reaches the brain. This combination helps manage the motor symptoms of Parkinson’s disease. It is not used for multiple sclerosis.
C. Riluzole is used primarily for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons. It works by reducing the release of glutamate, a neurotransmitter that can be toxic to nerve cells. Riluzole is not used for multiple sclerosis.
D. Interferon-beta is a disease-modifying therapy used in the treatment of multiple sclerosis. It works by modulating the immune system to reduce the frequency and severity of MS relapses. Interferon-beta can help slow the progression of disability and reduce the number of new lesions seen on MRI scans.

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A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

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Naxlex Comprehensive Predictor Exams

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Explanation

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