Which of the following are common assessment findings in a client with panhypopituitarism? (Select All that Apply.)

hypernatremia and hypertension

hypotension and tachycardia

increased bone density due to decreases in growth hormone

hypoglycemia due to decreased ACT and cortisol

decreased ability to cope with stress secondary to decreased cortisol -

hyperkalemia secondary to decreased aldosterone

Answer and Explanation

Correct Answer : B,D,E,F

A. Hypernatremia and hypertension is incorrect. In panhypopituitarism, adrenal insufficiency from decreased ACTH results in hyponatremia and hypotension, not hypernatremia and hypertension.
B. Hypotension and tachycardia is correct. Due to decreased ACTH, there is reduced cortisol and aldosterone, leading to low blood pressure and compensatory tachycardia.
C. Increased bone density due to decreases in growth hormone is incorrect. Growth hormone deficiency actually results in decreased bone density, not increased. GH plays a critical role in bone growth and maintenance.
D. Hypoglycemia due to decreased ACTH and cortisol is correct. Without sufficient cortisol, glucose regulation is impaired, increasing the risk of hypoglycemia.
E. Decreased ability to cope with stress secondary to decreased cortisol is correct. Cortisol is essential for the stress response, and its deficiency leads to poor tolerance to physical and emotional stress.
F. Hyperkalemia secondary to decreased aldosterone is correct. Low ACTH leads to adrenal insufficiency, which can reduce aldosterone production, causing sodium loss and potassium retention (hyperkalemia).

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Correct Answer is C

Explanation

A. Hypoactive deep tendon reflexes is incorrect. Hypocalcemia often leads to hyperactive reflexes, not hypoactive reflexes. This is because calcium plays a role in muscle and nerve function, and a deficiency can cause heightened neuromuscular irritability.
B. Constipation is incorrect. Constipation is more commonly associated with hypercalcemia (elevated calcium levels), not hypocalcemia. Low calcium levels tend to cause muscle spasms and neuromuscular symptoms rather than gastrointestinal issues.
C. Tingling of the extremities is correct. Tingling or paresthesia of the extremities is a common symptom of hypocalcemia. It occurs due to increased nerve excitability caused by low calcium levels, which can lead to muscle cramps, tetany, and numbness.
D. Shortened QT intervals is incorrect. A shortened QT interval is typically associated with hypercalcemia (high calcium levels), not hypocalcemia. Hypocalcemia is more likely to cause a prolonged QT interval on the ECG.

A. Require staff nurses to demonstrate competency by passing a medication administration examination. B. Review the events leading up to each medication administration error. C. Develop a quality improvement program for nurses involved in medication administration errors. D. Provide an in-service on medication administration to all the nurses.

Correct Answer is B

Explanation

A. Require staff nurses to demonstrate competency by passing a medication administration examination is incorrect. While testing competency may be part of the solution later, it is not the first step. The CQI process should begin by understanding why errors occurred, not by immediately requiring examinations without understanding the root causes.
B. Review the events leading up to each medication administration error is correct. The first step in a Continuous Quality Improvement (CQI) program should be to gather data and analyze the root causes of the medication errors. By reviewing the events that led to the errors, the committee can identify systemic problems, whether related to processes, communication, or individual actions. This approach helps to focus the improvement efforts on addressing the actual causes of the errors rather than just treating the symptoms.
C. Develop a quality improvement program for nurses involved in medication administration errors is incorrect. Developing a quality improvement program is an important step, but the first step in CQI is to gather and analyze data to identify why errors are occurring. The program should be based on findings from the error reviews.
D. Provide an in-service on medication administration to all the nurses is incorrect. While education and in-service training are useful for improving practice, the first step in CQI is to identify the problem. The committee needs to understand the reasons behind the medication errors before implementing training programs.

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Which of the following are common assessment findings in a client with panhypopituitarism? (Select All that Apply.)

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