The nurse is preparing a female client with Addison's disease for self-care afi.4 discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?

The drug may be needed to treat a sudden systemic allergic reaction.

Hypertensive crisis requires immediate treatment to prevent a stroke.

Hyperglycemia may require cortisol to lower the blood glucose level.

Stress increases the body's need for additional replacement hormone.

Answer and Explanation

The Correct Answer is D

A) The drug may be needed to treat a sudden systemic allergic reaction:

While cortisol may play a role in managing allergic reactions by suppressing inflammation, the primary reason for carrying a cortisol kit in Addison's disease is not typically related to managing allergic reactions.

B) Hypertensive crisis requires immediate treatment to prevent a stroke:

Hypertensive crisis may occur in some individuals with Addison's disease due to adrenal insufficiency, but the immediate treatment for this would typically involve fluids and intravenous hydrocortisone rather than carrying a cortisol kit for self-administration.

C) Hyperglycemia may require cortisol to lower the blood glucose level:

Cortisol can indeed influence blood glucose levels, but the need to carry a cortisol kit is primarily related to the management of adrenal insufficiency rather than hyperglycemia alone.

D) Stress increases the body's need for additional replacement hormone:

Correct. Individuals with Addison's disease have insufficient production of cortisol and often also lack aldosterone. During times of stress, such as illness, trauma, or surgery, the body's demand for cortisol increases to help cope with the stress. Inadequate cortisol production during stress can lead to adrenal crisis, a life-threatening condition. Therefore, carrying a cortisol kit allows the individual to promptly administer additional replacement hormone (usually hydrocortisone) during times of stress to prevent adrenal crisis.

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Correct Answer is D

Explanation

A) Sensory neuropathy:

Sensory neuropathy, while common in diabetes mellitus, primarily affects sensation in the extremities and can lead to reduced pain perception and protective sensation. While sensory neuropathy can contribute to the development of foot ulcers by reducing the ability to detect trauma or pressure, it is not the primary factor influencing the ability of the ulcer to heal.

B) Hyperlipidemia:

Hyperlipidemia, characterized by elevated levels of lipids (cholesterol and triglycerides) in the blood, is a common comorbidity in diabetes mellitus. It can contribute to the development of atherosclerosis and macrovascular complications such as coronary artery disease and peripheral arterial disease. While macrovascular disease can impair wound healing by reducing blood flow to the affected area, it is not the primary contributing factor to the ability of the ulcer to heal.

C) Ketoacidosis:

Ketoacidosis, a serious complication of uncontrolled diabetes mellitus, results from the accumulation of ketones in the blood, leading to metabolic acidosis. While ketoacidosis can have systemic effects and impair overall health, it is not directly related to the ability of a foot ulcer to heal.

D) Microvascular changes:

Correct. Microvascular changes, such as thickening of the capillary basement membrane and endothelial dysfunction, are hallmark features of diabetes mellitus. These changes lead to impaired microcirculation, reduced oxygen delivery, and compromised nutrient supply to tissues, including the skin and soft tissues of the foot. Poor microvascular perfusion contributes to delayed wound healing and an increased risk of infection in individuals with diabetes mellitus. Addressing microvascular changes is essential for promoting wound healing in diabetic foot ulcers, making it the primary contributing factor to the ability of the ulcer to heal.

A. Inflammation results from deposition of crystals in the synovial space of joints producing irritation. B. Inflammation is caused by immune complex and autoantibody deposition in connective tissue. C. Joint inflammation occurs when chondrocyte injury destroys joint cartilage, producing osteophytes. D. Joint destruction happens due to an autoimmune inflammation involving IgG response to an antigen.

Correct Answer is C

Explanation

Chronic osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown of joint cartilage and underlying bone changes. The pathophysiological process of OA involves various factors contributing to joint pain and inflammation. Here's why option C is the correct choice:

A) Inflammation results from deposition of crystals in the synovial space of joints producing irritation:

This statement is more characteristic of crystal-induced arthritis, such as gout or pseudogout, where crystals (e.g., urate or calcium pyrophosphate crystals) deposit in the joints and cause acute inflammation and irritation. While inflammation may occur in OA, it is primarily a result of mechanical stress and cartilage degradation rather than crystal deposition.

B) Inflammation is caused by immune complex and autoantibody deposition in connective tissue:

This statement is more characteristic of autoimmune diseases such as rheumatoid arthritis (RA), where immune complex deposition and autoantibody production lead to chronic inflammation and joint damage. In OA, inflammation is not primarily mediated by immune complex deposition or autoantibodies.

C) Joint inflammation occurs when chondrocyte injury destroys joint cartilage, producing osteophytes:

Correct. In osteoarthritis, joint inflammation occurs as a result of chondrocyte injury and cartilage breakdown. Over time, the degenerative changes in the joint lead to the formation of osteophytes (bone spurs) at the joint margins. These changes can irritate surrounding tissues, including the synovium, ligaments, and tendons, contributing to joint pain and inflammation.

D) Joint destruction happens due to an autoimmune inflammation involving IgG response to an antigen:

This statement is more characteristic of autoimmune arthritis, such as rheumatoid arthritis (RA), where autoantibodies (e.g., rheumatoid factor, anti-citrullinated protein antibodies) target joint tissues, leading to chronic inflammation and joint destruction. In OA, joint destruction primarily results from mechanical stress and wear-and-tear on the joint structures rather than autoimmune mechanisms.

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The nurse is preparing a female client with Addison's disease for self-care afi.4 discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?

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Naxlex Comprehensive Predictor Exams

A client with diabetes mellitus develops an ulcer on the bottom of the foot. Which pathology is the primary contributing factor to the ability of the ulcer to heal?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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