A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?
IV hydrocortisone
Ketoconazole and insulin
Lactated Ringer's IV infusion
Furosemide slow IV push
The Correct Answer is A
A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Acetaminophen: While acetaminophen can help manage fever, it is not a primary treatment for acute thyrotoxicosis. The management of acute thyrotoxicosis involves addressing the overproduction of thyroid hormones, not just symptom relief.
B. Furosemide: Furosemide is a diuretic used for fluid retention and hypertension, not for managing thyrotoxicosis. It does not address the underlying cause of acute thyrotoxicosis.
C. Ketoconazole: Ketoconazole is an anti-fungal medication that also has the effect of inhibiting cortisol synthesis and can be used to treat acute thyrotoxicosis by reducing the production of thyroid hormones. It is used as part of a broader treatment plan.
D. Levothyroxine: Levothyroxine is used to treat hypothyroidism by providing synthetic thyroid hormone. It is not used to treat thyrotoxicosis, which involves excessive thyroid hormone levels, not deficiency.
Correct Answer is B
Explanation
A. Levothyroxine replacement test: This test is used to assess the thyroid's response to synthetic thyroid hormone and is not used to differentiate types of hyperthyroidism.
B. Radioactive iodine uptake (RAIU) test: This test measures the thyroid gland's ability to absorb iodine, which helps differentiate Graves' disease (characterized by increased uptake) from other forms of hyperthyroidism, such as thyroiditis (which may show decreased uptake).
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test is used to evaluate adrenal function and is not relevant for diagnosing or differentiating forms of hyperthyroidism.
D. Subtotal thyroidectomy: This is a surgical procedure rather than a diagnostic test and would not be used to differentiate between types of hyperthyroidism.
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