The nurse is caring for a patient who was treated for Addisonian crisis.
What clinical change indicates to the nurse that the prescribed therapy was effective?
Increase of 25 mmHg in the patient's systolic blood pressure.
An increase in the serum potassium level from 3.5 to 5.6 mEq/dL.
Patient complains of headache and is showing signs of restlessness.
The patient has normal temperature with pallor to the skin.
The Correct Answer is A
Choice A rationale
An increase in systolic blood pressure by 25 mmHg indicates a positive response to therapy for Addisonian crisis. Addisonian crisis involves severe hypotension due to low levels of cortisol and aldosterone, which regulate blood pressure. Cortisol replacement therapy helps to increase blood pressure by enhancing the responsiveness of blood vessels to catecholamines and promoting sodium and water retention. This improvement is critical for stabilizing the patient and restoring hemodynamic balance.
Choice B rationale
An increase in serum potassium level from 3.5 to 5.6 mEq/dL suggests hyperkalemia, which is a sign of worsening condition, not improvement. Addisonian crisis is characterized by hyperkalemia due to aldosterone deficiency, which impairs potassium excretion. Effective treatment would normalize potassium levels rather than increase them.
Choice C rationale
Complaints of headache and signs of restlessness may indicate adverse effects or complications, rather than therapeutic efficacy. These symptoms could result from inadequate or excessive dosing of corticosteroids or other underlying issues. Monitoring patient response and adjusting treatment is essential.
Choice D rationale
Normal temperature with pallor to the skin does not indicate effective therapy for Addisonian crisis. Pallor may reflect ongoing hypoperfusion or anemia. The absence of fever is not a definitive marker of therapeutic success. Key indicators include hemodynamic stability and normalized electrolytes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Prevent graft versus host disease (GVHD) is a common complication following an allogeneic stem cell transplant. Immunosuppressant medications are given to prevent the donor immune cells from attacking the recipient's body tissues, which is GVHD. This prevention is crucial for the success of the transplant and the patient's overall recovery.
Choice B rationale
Prevent graft rejection is more commonly associated with solid organ transplants like kidney or liver transplants. In the context of stem cell transplants, preventing GVHD is the primary concern rather than preventing graft rejection.
Choice C rationale
Preventing hospital-acquired infections is important for all patients, especially those with compromised immune systems. However, this is not the primary indication for immunosuppressant medications following an allogeneic stem cell transplant. Other measures, such as infection control protocols, are more directly related to this.
Choice D rationale
Preventing a relapse of leukemia is a key goal of the overall treatment plan for leukemia patients. However, immunosuppressant medications do not directly prevent a relapse; instead, they help manage complications like GVHD that can arise from the transplant process.
Correct Answer is ["5"]
Explanation
The correct answer is 5.
Step 1 is 0.5 mg × 1000 mcg ÷ 1 mg = 500 mcg.
Step 2 is 500 mcg ÷ 100 mcg/min = 5 min.
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