A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Assess for neck vein distention

Monitor for postural hypotension

Assess blood glucose level

Monitor for an irregular heart rate

Weigh the client daily

Answer and Explanation

Correct Answer : A,C,D,E

A. Assess for neck vein distention: Neck vein distention can occur in Cushing's syndrome due to fluid retention and hypertension. It is an important sign to monitor as it can indicate complications like heart failure.

B. Monitor for postural hypotension: Clients with Cushing's syndrome typically have hypertension rather than hypotension. Therefore, postural hypotension is not a common issue to monitor for in these patients.

C. Assess blood glucose level: Hyperglycemia is common in Cushing's syndrome due to increased cortisol levels, which promote glucose production and reduce glucose uptake by cells. Monitoring blood glucose is essential to manage this condition.

D. Monitor for an irregular heart rate: Cushing's syndrome can cause electrolyte imbalances (like hypokalemia), which may lead to cardiac arrhythmias, so monitoring for an irregular heart rate is important.

E. Weigh the client daily: Daily weight monitoring helps track fluid retention, which is common in Cushing's syndrome due to cortisol-induced fluid retention. This can help in managing the client’s fluid status and detecting worsening of symptoms.

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Correct Answer is B

Explanation

A. Aortic stenosis: While aortic stenosis can cause fatigue and dyspnea, it typically presents with a systolic murmur and symptoms related to reduced blood flow out of the left ventricle, such as syncope or angina. However, tachycardia and weak pulses are less characteristic without advanced disease and heart failure.

B. Heart failure: Dyspnea, fatigue, tachycardia, and weak peripheral pulses are common manifestations of heart failure. The heart's inability to pump effectively leads to reduced cardiac output and poor perfusion of tissues, resulting in these symptoms

C. Asthma: Asthma is characterized primarily by respiratory symptoms like wheezing, shortness of breath, and coughing, especially during an attack. It does not typically cause tachycardia and weak peripheral pulses as a primary manifestation.

D. Aortic valve regurgitation: This condition can lead to symptoms like dyspnea and fatigue due to decreased cardiac efficiency, but it more commonly presents with a diastolic murmur, wide pulse pressure, and a characteristic bounding pulse rather than weak peripheral pulses.

A. Ketones present in urine B. Elevated C-peptide blood level C. Serum blood glucose 300 mg/dL D. HbA1c 12.6% E. Hypertension F. ABG results

Correct Answer is ["A","C","D","F"]

Explanation

☑️ Ketones present in urine: The presence of ketones in urine indicates that the body is breaking down fats for energy due to insufficient insulin, a hallmark of DKA. This ketogenesis occurs when the body cannot utilize glucose properly, leading to the production of ketone bodies which are excreted in the urine.

☐ Elevated C-peptide blood level: Elevated C-peptide levels typically indicate that the pancreas is still producing insulin. In the context of DKA, particularly in Type 1 diabetes, C-peptide levels are usually low or undetectable due to the lack of insulin production. Therefore, elevated C-peptide is not a risk factor for DKA.

☑️ Serum blood glucose 300 mg/dL: Elevated blood glucose levels (≥250 mg/dL) are a significant risk factor for DKA. Hyperglycemia indicates poor glycemic control, which, if prolonged and severe, can lead to ketone production and subsequent ketoacidosis.

☑️ HbA1c 12.6%: An HbA1c level of 12.6% indicates chronic poor blood glucose control. A normal HbA1c is below 5.7%, and levels above 6.5% suggest diabetes. This very high level suggests persistent hyperglycemia, increasing the risk for acute complications like DKA.

☐ Hypertension: Hypertension is not directly related to DKA. While it is a common comorbidity in diabetes, it does not contribute to the metabolic conditions leading to ketoacidosis. DKA is more closely related to hyperglycemia, insulin deficiency, and increased ketone production rather than blood pressure levels.

☑️ ABG results: The ABG results indicate metabolic acidosis, a hallmark of DKA. The low pH (7.20) and low bicarbonate (HCO3- at 12 mEq/L) confirm acidosis, and in the context of hyperglycemia and ketonuria, it strongly suggests DKA. The normal PaCO2 suggests that there is no significant respiratory compensation for the metabolic acidosis.

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A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is assessing a client who reports dyspnea and fatigue. Physical assessment reveals tachycardia and weak peripheral pulses. The nurse should recognize these findings as manifestations of which of the following conditions?

Correct Answer is B

Explanation

A nurse is caring for a client in the emergency department. Exhibits Which of the following assessment findings would indicate to the nurse that the client is at risk for developing diabetic ketoacidosis (DKA)? (Select All that Apply.)

Correct Answer is ["A","C","D","F"]

Explanation

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