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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The loop of Henle, a critical structure within the nephron of the kidney, plays a key role in the concentration of urine through the process of countercurrent multiplication. Here's why option D is the correct choice:
A) Calyx:
The calyx is a structure in the kidney that collects urine from the renal papillae and channels it into the renal pelvis. It does not directly participate in the concentration of urine.
B) Proximal convoluted tubule:
The proximal convoluted tubule primarily reabsorbs water, electrolytes, and nutrients from the glomerular filtrate, but it does not contribute significantly to the concentration of urine.
C) Renal pelvis:
The renal pelvis is a funnel-shaped structure that collects urine from the calyces and funnels it into the ureter. It is not directly involved in the concentration of urine.
D) The loop of Henle:
Correct. The loop of Henle is the nephron segment responsible for generating a hypertonic medullary interstitium, which creates the osmotic gradient necessary for urine concentration. The loop of Henle achieves this through countercurrent multiplication, where the descending limb allows passive reabsorption of water, while the ascending limb actively pumps out sodium and chloride ions. This creates an osmotic gradient that allows for further water reabsorption in the collecting ducts, leading to concentrated urine.
Correct Answer is C
Explanation
The ABG results indicate respiratory acidosis (pH 7.0, PaCO2 66 mmHg) with compensatory metabolic alkalosis (HCO3- 24 mEq/L). The low PaO2 (60 mmHg) suggests hypoxemia.
pH 7.0: The pH is below the normal range (7.35 to 7.45), indicating acidosis.
PaCO2 66 mmHg: The PaCO2 is elevated above the normal range (35 to 45 mmHg), indicating respiratory acidosis.
HCO3- 24 mEq/L: The bicarbonate level is within the normal range (21 to 28 mEq/L), indicating compensatory metabolic alkalosis.
PaO2 60 mmHg: The PaO2 is decreased below the normal range (80 to 100 mmHg), indicating hypoxemia.
These findings suggest that the client is experiencing respiratory failure, which is characterized by inadequate gas exchange resulting in hypoxemia and hypercapnia. In this case, the massive pulmonary embolus is causing ventilation-perfusion (V/Q) mismatch, leading to impaired gas exchange and respiratory compromise. Tachycardia, hypotension, and audible bilateral pulmonary crackles further support the diagnosis of respiratory failure in the context of a massive pulmonary embolus.
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