The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg

Serum phosphorus 3 mg/dL and hirsutism

Serum calcium 10 mg/dl, and reports of feelings of depression

Serum sodium 145 mEq/L and reports of muscle weakness

Answer and Explanation

The Correct Answer is A

A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.

B. Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.

C. Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.

D. Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.

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Correct Answer is B

Explanation

A. Obtaining a culture of the drainage may be necessary, but the immediate concern is to determine if the drainage is cerebrospinal fluid (CSF) or another type of fluid. Checking for glucose content is a rapid way to differentiate CSF from other fluids.

B. Correct. Clear drainage from the nose post-transsphenoidal hypophysectomy may indicate a CSF leak, which is a potential complication. Checking the drainage for glucose can help differentiate CSF from other fluids, as CSF contains glucose. If the drainage tests positive for glucose, it indicates the presence of CSF.

C. Documenting the amount of drainage is important, but determining the nature of the drainage (CSF or other fluid) takes precedence in this situation.

D. Notifying the client's provider is important, but the nurse should gather information about the drainage first by checking for glucose content. This information will be crucial for the healthcare provider to make decisions about further interventions

A. Check the pedal pulses. B. Request prescription for a relaxant. C. Verify the most recent calcium level. D. Administer an oral potassium supplement.

Correct Answer is C

Explanation

A. Checking the pedal pulses is important for assessing circulation, but it may not directly address the cause of the muscle spasms. In this case, addressing the electrolyte imbalance is a higher priority.

B. Requesting a relaxant might provide temporary relief for muscle spasms, but it does not address the potential underlying cause. It's important to identify and treat the root issue.

C. Correct. Severe muscle spasms in a client post-thyroidectomy could indicate hypocalcemia, as the parathyroid glands, which regulate calcium levels, can be affected during the surgery. Verifying the most recent calcium level will help determine if this is the cause.

D. Administering an oral potassium supplement addresses a different electrolyte imbalance (hypokalemia), which is not typically associated with muscle spasms following a thyroidectomy. Calcium levels are more relevant in this context.

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The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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