A patient is admitted to the hospital in Addisonian Crisis a month after a diagnosis of Addison’s disease. The nurse identifies the nursing diagnosis of ineffective therapeutic regimen management related to lack of knowledge of management of the condition when the patient says:
“I double my dose of hydrocortisone on the days that I go for a run.”
“I had the stomach flu earlier this week and couldn't take the hydrocortisone.”
“I frequently eat at restaurants, and so my food has a lot of added salt."
“I do yoga exercises almost every day to help me reduce stress and relax.”
The Correct Answer is B
The statement "I had the stomach flu earlier this week and couldn't take the hydrocortisone" indicates that the patient may not be adhering to their prescribed medication regimen, which can lead to an Addisonian crisis. Therefore, the nursing diagnosis of ineffective therapeutic regimen management related to lack of knowledge of management of the condition is appropriate.
Addison’s disease is a condition in which the adrenal glands do not produce enough cortisol and aldosterone. Hydrocortisone is a glucocorticoid medication that is often used to replace the cortisol that the adrenal glands are not producing. In the Addisonian crisis, the body is unable to produce the necessary levels of cortisol and aldosterone, which can lead to potentially life-threatening complications such as hypotension, dehydration, and electrolyte imbalances.
The other statements may indicate areas where patient education is needed, but they do not directly relate to the immediate risk of an Addisonian crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Broccoli and kale are good sources of calcium, and by adding them to their diet, the client can increase their calcium intake without consuming milk. It is important to note that some calcium supplements may irritate the stomach but stopping them altogether is not advisable without consulting a healthcare provider. Vitamin D is not a milk product, and it is essential for calcium absorption. Avoiding foods with vitamin D can worsen the low calcium levels. Cheese is a milk product and may not be suitable for someone with a milk allergy.
Correct Answer is C
Explanation
The patient with primary hyperparathyroidism has high levels of calcium in the blood (hypercalcemia) which can lead to symptoms such as kidney stones, bone pain, and weakness. High urine calcium levels may also be present due to the increased calcium in the blood.
One important intervention for managing hypercalcemia is to encourage fluid intake to promote increased urine output and prevent the formation of kidney stones. Therefore, the nurse should encourage the patient to drink at least 4000 ml of fluids per day.
Seizure precautions (a), range-of-motion exercises (b), and monitoring for positive Chvostek’s or Trousseaus sign (d) are not directly related to managing hypercalcemia and are not necessary in this case.
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