A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

Hypernatremia

Fluid volume overload

Hypokalemia

Hypoglycemia

Answer and Explanation

The Correct Answer is D

A.   Hypernatremia (elevated sodium levels) is not a common sign of Addisonian crisis. In Addisonian crisis, the lack of aldosterone leads to sodium loss, which often results in hyponatremia (low sodium levels) rather than hypernatremia. The patient might also experience dehydration and electrolyte imbalances, but hypernatremia is not typical in this scenario.
B.   Fluid volume overload is not characteristic of Addisonian crisis. Instead, Addisonian crisis often leads to fluid volume deficit due to the loss of aldosterone, which impairs sodium and water retention. This can result in dehydration and low blood volume rather than fluid overload.
C.   Hypokalemia (low potassium levels) is not typically associated with Addisonian crisis. In fact, the lack of aldosterone in Addisonian crisis leads to potassium retention, resulting in hyperkalemia (elevated potassium levels). Therefore, monitoring for hypokalemia is not relevant in the context of Addisonian crisis following a bilateral adrenalectomy.
D.   Hypoglycemia (low blood glucose levels) is a key sign of Addisonian crisis. Cortisol plays a crucial role in glucose metabolism and maintaining blood glucose levels. With the loss of cortisol production after a bilateral adrenalectomy, patients may experience hypoglycemia, which can be a critical indicator of Addisonian crisis.

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Correct Answer is A

Explanation

A. Pursed-lip breathing is an effective technique for managing COPD symptoms, particularly tachypnea and dyspnea. It helps to keep the airways open by creating back pressure that prevents the collapse of bronchioles and reduces air-trapping. This technique improves ventilation and helps with the expiration of trapped air, making it a valuable intervention for COPD patients.
B. The Trendelenburg position involves lying flat on the back with the legs elevated higher than the head. This position is not suitable for managing COPD symptoms and can actually worsen breathing difficulties by increasing abdominal pressure on the diaphragm.
C. High-frequency chest wall oscillation (HFCWO) vests are used to help with airway clearance in conditions like cystic fibrosis or chronic bronchitis by loosening mucus. While beneficial for mucus management, they do not specifically address bronchiolar collapse or air-trapping associated with COPD.
D. Measuring the FEV1/FVC ratio is a diagnostic tool used to assess the severity of airflow obstruction in COPD. While this information is important for diagnosis and treatment planning, it is not an immediate intervention to manage symptoms such as tachypnea and dyspnea.

A. Increased sensitivity to cold on the affected side B. Drooling from the corner of the mouth on the affected side C. Ringing in the ear on the affected side D. Drooping of the upper lid margin in one eye

Correct Answer is D

Explanation

A. Increased sensitivity to cold is not typically associated with Bell's Palsy or ptosis but might be a general sensation change related to nerve involvement.
B. Drooling from the corner of the mouth is a result of facial weakness affecting the muscles responsible for controlling saliva and mouth closure. While drooling is a common symptom of Bell's Palsy due to impaired muscle control, it is not a description of ptosis. Ptosis specifically refers to the drooping of the upper eyelid.
C. Ringing in the ear, or tinnitus, is not a direct symptom of ptosis. Tinnitus might be associated with various conditions affecting the ear or cranial nerves but is not specifically indicative of ptosis, which is related to eyelid drooping.
D. Ptosis refers to the drooping or sagging of the upper eyelid. In the context of Bell's Palsy, this drooping occurs on the affected side due to weakness or paralysis of the muscles that normally help elevate the eyelid.

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A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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