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
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).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Bed sheet is a common item considered a safety risk in real clinical settings, but in this specific safety exercise, it was not the item identified as being on the back of the chair.
B. Patient gown is typically worn by the client and would not usually be placed on the back of a chair as a risk item during a safety evaluation.
C. Beige jacket is correct. In the safety exercise scenario, the beige jacket was on the back of the chair, and it could pose a ligature risk, making it a key item of concern in suicide prevention protocols.
D. Blow dryer may be a potential safety risk in general, but it was not the item noted on the back of the chair in the described scenario.
Correct Answer is A
Explanation
A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.
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