The nurse is caring for a patient with Addison's disease in the emergency department.
The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?

Administer intravenous fluids with glucose.

Administer 1000 mg of acetaminophen orally.

Educate the patient about ordered hydrocortisone.

Explore options to minimize stress.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Administering intravenous fluids with glucose is essential for a patient with Addison's disease who has been exposed to stressors like prolonged sun exposure. Patients with Addison's disease may experience an adrenal crisis, characterized by low blood pressure, dehydration, and hypoglycemia. Intravenous fluids with glucose help to rehydrate the patient and restore blood sugar levels, which are critical in preventing shock and other severe complications.

Choice B rationale

Administering 1000 mg of acetaminophen orally is not the priority intervention for this patient. While it may help reduce fever, it does not address the underlying issues of Addison's disease, such as hypoglycemia and dehydration, which are more urgent. The primary concern should be stabilizing the patient's vital signs and electrolyte balance.

Choice C rationale

Educating the patient about ordered hydrocortisone is important for long-term management of Addison's disease, but it is not the immediate priority in an emergency situation. The patient requires prompt medical intervention to address the acute symptoms of adrenal insufficiency, such as lethargy and hypoglycemia.

Choice D rationale

Exploring options to minimize stress is relevant for managing Addison's disease in general, as stress can trigger an adrenal crisis. However, in the emergency department, the nurse's priority should be to stabilize the patient and manage acute symptoms. Stress management can be addressed once the patient's condition is stabilized.

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Correct Answer is A

Explanation

Choice A rationale

Dairy milk is a rich source of calcium, which is essential for patients with hypoparathyroidism. This condition leads to low levels of parathyroid hormone, causing hypocalcemia (low calcium levels in the blood). Including calcium-rich foods like dairy milk helps to manage this deficiency and maintain normal calcium levels.

Choice B rationale

Eggs provide some calcium, but their primary nutritional value is their protein content. While beneficial for overall health, eggs alone are not sufficient to address the calcium needs of patients with hypoparathyroidism, who require higher calcium intake.

Choice C rationale

Spinach contains calcium; however, it also has high levels of oxalates, which can bind to calcium and reduce its absorption in the body. Therefore, relying on spinach for calcium intake is not ideal for patients with hypoparathyroidism, who need to maximize calcium absorption to manage their condition effectively.

Choice D rationale

Green beans are nutritious and provide some calcium, but they are not among the top sources of calcium required for managing hypoparathyroidism. Patients with this condition need higher calcium intake from more concentrated sources like dairy products.

A. Insert nasogastric tube and begin enteral feeding. B. Teach the patient to increase protein intake and to eat five to seven times a day. C. Implement strict NPO status and initiate total parenteral nutrition (TPN). D. Teach the patient to rinse their mouth with alcohol-based mouthwash prior to meals.

Correct Answer is A

Explanation

Choice A rationale

For a client with severe malnutrition, immediate intervention is necessary to address nutritional deficiencies. Inserting a nasogastric tube and beginning enteral feeding is the first step to provide essential nutrients, stabilize the patient's condition, and prevent further complications from malnutrition.

Choice B rationale

Teaching the patient to increase protein intake and to eat more frequently is important but not the immediate priority in a case of severe malnutrition. This can be addressed after initial stabilization and nutritional support.

Choice C rationale

Total parenteral nutrition (TPN) is an option for patients who cannot tolerate enteral feeding, but initiating strict NPO status without first attempting enteral feeding is not the best initial approach. Enteral feeding is generally preferred if the gastrointestinal tract is functional.

Choice D rationale

Rinsing the mouth with alcohol-based mouthwash before meals is not a priority in managing severe malnutrition. It does not address the immediate need for nutritional support and could be harmful if ingested.

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The nurse is caring for a patient with Addison's disease in the emergency department.The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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The nurse is caring for a patient with Addison's disease in the emergency department.
The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?