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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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Age-related hearing loss, also known as presbycusis, is a common condition among older adults. It typically involves a gradual decline in hearing ability due to changes in the inner ear or auditory nerve as people age. This statement acknowledges a common experience and helps normalize the patient's condition without suggesting immediate medical intervention or attributing it to something specific.
B. While hearing aids can significantly improve the quality of life for individuals with hearing loss, not all cases immediately require them. It’s important to assess the severity of hearing loss and discuss various options with the patient, including potential benefits and drawbacks of hearing aids.
C. Hearing loss that develops gradually over time is usually related to aging, not an infection. While infections can cause temporary hearing loss, age-related hearing loss is a different issue and is typically not due to an infection.
D. While some medications can cause temporary or permanent hearing loss as a side effect (a condition known as ototoxicity), it’s important to consult a healthcare provider before making any changes to medication regimens.

A. Place client on total bedrest and avoid use of affected joints B. Provide warm compresses to affected joints C. Place several pillows under the head to keep the neck in a flexed position D. Place the client on continuous cardiac monitoring E. Administer methylprednisolone as ordered

Correct Answer is ["B","E"]

Explanation

A. Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B. Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C. Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D. Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E. Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.

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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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