A nurse is caring for a client with a urine specific gravity of less than 1.005, polyuria, and nocturia. The nurse recognizes that which of the following physiologic findings is the likely cause?

Increased insulin production

Increased adrenocorticotropic hormone (ACTH)

Low levels of T3, T4

Insufficient antidiuretic hormone (ADH)

Answer and Explanation

The Correct Answer is D

A. Increased insulin production would not cause polyuria and low specific gravity urine; rather, hyperglycemia from lack of insulin can cause high specific gravity due to glucose in urine.
B. Increased ACTH affects cortisol production but is not directly related to urine concentration or polyuria.
C. Low T3 and T4 levels are associated with hypothyroidism, which typically does not cause polyuria or decreased specific gravity.
D. Insufficient ADH, as seen in diabetes insipidus, leads to the inability to concentrate urine, resulting in a low specific gravity, polyuria, and nocturia due to excessive water loss.

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Correct Answer is A

Explanation

A. Chvostek's sign, a facial muscle spasm upon tapping, is a clinical indicator of hypocalcemia, often caused by accidental removal or damage to the parathyroid glands during thyroid surgery.
B. Hypercalcemia does not typically cause a positive Chvostek’s sign.
C. Hypokalemia affects muscle and cardiac function but does not result in a positive Chvostek’s sign.
D. Hyponatremia does not produce Chvostek's sign, which is specific to hypocalcemia.

Correct Answer is []

Explanation

Rationale:

Potential Condition: Hypothyroidism - The client exhibits signs consistent with hypothyroidism, including fatigue, weight gain, decreased appetite, hair loss, constipation, and intolerance to cold. The laboratory results show low serum T3 and T4 levels, confirming this diagnosis.
Actions to Take:
- Request a prescription for Thyroid hormone replacement: This is crucial for managing hypothyroidism and restoring normal metabolic function.
- Administer supplemental oxygen: Given the client’s low oxygen saturation (92%), this intervention is essential to ensure adequate oxygen delivery and prevent further complications.
Parameters to Monitor:
- Bowel function: Monitoring bowel habits is important since constipation is a common symptom of hypothyroidism, and managing this aspect can improve the patient's overall comfort and health.
- Oxygen saturation: Continuous assessment of oxygen levels is necessary to address the patient's respiratory needs and detect any further deterioration.

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A nurse is caring for a client with a urine specific gravity of less than 1.005, polyuria, and nocturia. The nurse recognizes that which of the following physiologic findings is the likely cause?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following a subtotal thyroidectomy. The nurse assesses for the presence of Chvostek's sign to indicate which of the following electrolyte imbalances?

Correct Answer is A

Explanation

Correct Answer is []

Explanation

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