A patient with pheochromocytoma
is admitted to the hospital with severe hypertension. Which nursing intervention is the highest priority?
Administering an alpha-adrenergic blocker as prescribed.
Administering intravenous fluids to maintain hydration.
Monitoring blood glucose levels every 4 hours.
Preparing the patient for immediate surgery to remove the tumor.
The Correct Answer is A
Choice A Reason:
Administering an alpha-adrenergic blocker is the highest priority intervention for a patient with pheochromocytoma and severe hypertension. Pheochromocytoma causes excessive secretion of catecholamines, leading to severe hypertension. Alpha-adrenergic blockers help to control blood pressure by blocking the effects of these catecholamines, thereby reducing vasoconstriction and lowering blood pressure. This intervention is crucial to prevent hypertensive crises and associated complications such as stroke or myocardial infarction.
Choice B Reason:
Administering intravenous fluids to maintain hydration is important but not the highest priority. While maintaining hydration is essential, it does not directly address the severe hypertension caused by pheochromocytoma. Intravenous fluids can help support overall patient stability but do not specifically target the underlying cause of the hypertension.
Choice C Reason:
Monitoring blood glucose levels every 4 hours is a necessary intervention, especially since pheochromocytoma can cause hyperglycemia due to increased catecholamine levels. However, this intervention is not the highest priority compared to controlling the severe hypertension, which poses a more immediate threat to the patient’s health.
Choice D Reason:
Preparing the patient for immediate surgery to remove the tumor is a critical step in the long-term management of pheochromocytoma. However, surgery is not typically performed until the patient’s blood pressure is stabilized with medications such as alpha-adrenergic blockers. Therefore, while surgery is essential, it is not the immediate priority in the acute management of severe hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Testing blood glucose levels every 6 hours during illness is crucial for managing type 1 diabetes. Illness can cause blood glucose levels to fluctuate unpredictably, and frequent monitoring helps in making timely adjustments to insulin doses and dietary intake. This practice helps prevent both hyperglycemia and hypoglycemia, ensuring better overall control of diabetes during periods of illness.
Choice B Reason:
Administering the usual daily dose of insulin is important even during illness. Skipping insulin doses can lead to dangerously high blood glucose levels and increase the risk of diabetic ketoacidosis (DKA). It is essential to continue taking insulin as prescribed and to consult with a healthcare provider if any adjustments are needed based on blood glucose readings.
Choice C Reason:
Limiting juices, soda, and gelatin is not typically recommended during illness for patients with type 1 diabetes. These items can be useful for maintaining hydration and providing quick sources of carbohydrates if the patient is unable to eat solid foods. Instead of limiting these items, it is more important to monitor carbohydrate intake and adjust insulin doses accordingly.
Choice D Reason:
Reporting a blood glucose level greater than 300 is critical for preventing complications. High blood glucose levels can indicate the onset of DKA, a serious condition that requires immediate medical attention. Promptly reporting elevated blood glucose levels allows for timely intervention and management to prevent severe complications.
Correct Answer is B
Explanation
Choice A Reason:
Advising the patient to increase their screen time to exercise their eye muscles is not appropriate for managing macular degeneration. Increased screen time can cause eye strain and does not benefit the condition. Instead, patients should be encouraged to engage in activities that do not exacerbate eye strain.
Choice B Reason:
Encouraging the patient to quit smoking is a crucial intervention for managing macular degeneration. Smoking is a significant risk factor for the progression of macular degeneration. Quitting smoking can help slow the progression of the disease and improve overall eye health. This intervention addresses a modifiable risk factor and can have a positive impact on the patient’s condition.
Choice C Reason:
Suggesting the patient avoid all physical activities to prevent further eye damage is not necessary for managing macular degeneration. Physical activity is important for overall health and does not directly impact the progression of macular degeneration. Patients should be encouraged to maintain a healthy lifestyle, including regular physical activity.
Choice D Reason:
Informing the patient to reduce their water intake to prevent fluid accumulation in the eyes is not relevant for managing macular degeneration. Adequate hydration is important for overall health, and there is no evidence to suggest that reducing water intake will benefit patients with macular degeneration. This advice could potentially lead to dehydration and other health issues.
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