The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?
Pain 7/10 at the surgical site
Hyperglycemia
Blood pressure 92/50
Sodium 152 mEq/L
The Correct Answer is C
A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.
Correct Answer is D
Explanation
A. "I will include protein and carbohydrates in every meal": This is appropriate for a client with Graves' disease. A balanced diet with adequate protein and carbohydrates helps meet increased caloric needs due to hypermetabolism.
B. "I will avoid caffeinated beverages": This is a correct statement. Clients with Graves' disease should avoid caffeine as it can exacerbate symptoms like tremors and palpitations.
C. "I will eat a high-fiber diet": This is beneficial for maintaining gastrointestinal health. Hyperthyroidism can cause increased bowel movements, so a high-fiber diet helps prevent diarrhea.
D. "I will eat six full meals per day, with snacks in between": This indicates a need for further teaching. While frequent meals may be needed, "six full meals" can be excessive. Instead, a high-calorie, nutrient-dense diet with smaller, more frequent meals may be recommended to address increased metabolic demands without overloading the digestive system.
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