A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Osmolarity

Platelets

Albumin

Glucose

Answer and Explanation

The Correct Answer is D

Choice A reason: Osmolarity is a measure of the concentration of solutes in the blood. While it can be important in certain contexts, it is not the primary concern when monitoring a client with Addison's disease who is on hydrocortisone therapy.

Choice B reason: Platelets are a component of blood involved in clotting. Monitoring platelet count is important in certain conditions, but it is not the primary focus for a client with Addison's disease on hydrocortisone therapy.

Choice C reason: Albumin is a protein in the blood that helps maintain osmotic pressure and transport substances. While it is important to monitor albumin levels in some conditions, it is not the primary concern for a client with Addison's disease on hydrocortisone therapy.

Choice D reason: Glucose levels are crucial to monitor in clients with Addison's disease on hydrocortisone therapy. Hydrocortisone can affect glucose metabolism, potentially leading to hyperglycemia. Monitoring glucose levels helps ensure that the client's blood sugar remains within a safe range and allows for timely intervention if necessary.

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Correct Answer is B

Explanation

Choice A reason: Notifying the surgical team to cancel the surgery is premature without confirming the pregnancy status. While it is critical to consider the possibility of pregnancy before surgery, the decision to cancel should be based on confirmed information rather than a possibility.

Choice B reason: Performing a bedside pregnancy test is the most appropriate immediate intervention. This test can provide rapid confirmation of pregnancy status. If the client is pregnant, the surgical team can then evaluate the risks and benefits of proceeding with or postponing the surgery. Immediate confirmation helps guide clinical decision-making and ensures the safety of both the client and the potential fetus.

Choice C reason: Continuing with surgery as scheduled without confirming the pregnancy status is not appropriate. Anesthesia and surgical procedures can pose risks to a pregnant client and the fetus. It is essential to verify the pregnancy status to make an informed decision about the safety and necessity of the surgery.

Choice D reason: Calculating gestation from the last menstrual cycle can provide an estimate of the pregnancy duration, but it does not confirm pregnancy. A bedside pregnancy test should be performed first to confirm whether the client is pregnant before considering gestational age. This information can then be used to further assess the situation and plan appropriate care.

A. Hypotension and venous pooling in the extremities B. Reports of chest pain and shortness of breath C. Pain and a burning sensation upon urination and hematuria D. Profuse diaphoresis and severe, pounding headache

Correct Answer is D

Explanation

Choice A reason: Hypotension and venous pooling in the extremities are typically signs of neurogenic shock, which occurs immediately after a spinal cord injury. However, autonomic dysreflexia is characterized by severe hypertension, not hypotension. The symptoms in this scenario do not fit the presentation of autonomic dysreflexia.

Choice B reason: Reports of chest pain and shortness of breath are not the primary symptoms of autonomic dysreflexia. While autonomic dysreflexia can cause a variety of symptoms due to uncontrolled sympathetic nervous system activity, the hallmark symptoms are severe hypertension and headache, along with other specific signs like diaphoresis.

Choice C reason: Pain and a burning sensation upon urination and hematuria indicate a urinary tract infection or another urological issue, not autonomic dysreflexia. While a full bladder is a common trigger for autonomic dysreflexia, the symptoms described in this choice do not accurately reflect the condition.

Choice D reason: Profuse diaphoresis and a severe, pounding headache are classic symptoms of autonomic dysreflexia. This condition results from an overactive autonomic nervous system response to stimuli below the level of the injury, such as a full bladder. The resulting vasoconstriction leads to severe hypertension and symptoms like headache and sweating above the level of injury.

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A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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