The new graduate nurse asks the experienced nurse, Why does a client receive vasopressin after undergoing a hypophysectomy? How should the nurse respond?
To prevent syndrome of inappropriate antidiuretic hormone.
Vasopressin replaces antidiuretic hormone normally secreted by the pituitary.
Vasopressin reduces cerebral edema and lowers intracranial pressure.
The medication is administered IM to treat growth failure.
The Correct Answer is B
A hypophysectomy involves the surgical removal of the pituitary gland. Knowledge of endocrine physiology is required to understand the postoperative loss of posterior pituitary hormones and the necessity of exogenous replacement therapy to maintain fluid balance and prevent complications.
Choice A rationale
Syndrome of inappropriate antidiuretic hormone involves excessive ADH, whereas hypophysectomy results in a total deficiency. Vasopressin is given to prevent the opposite condition, diabetes insipidus, characterized by massive polyuria and severe fluid volume deficit.
Choice B rationale
The posterior pituitary stores and secretes antidiuretic hormone (ADH), also known as vasopressin. Removal of the gland eliminates the body's ability to concentrate urine, necessitating hormonal replacement to regulate water reabsorption in the kidneys.
Choice C rationale
Vasopressin is not primarily used to treat cerebral edema or intracranial pressure. While it affects fluid volume, medications like mannitol or corticosteroids are the standard pharmacological interventions for managing postoperative cerebral swelling and elevated pressure.
Choice D rationale
Vasopressin is an antidiuretic hormone, not a growth hormone. Growth failure is treated with somatropin. While pituitary removal stops growth hormone production, the immediate life-threatening concern postoperatively is the management of massive water loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This scenario requires applying knowledge of burn pathophysiology, specifically the emergent phase and fluid resuscitation. Understanding clinical indicators of hypovolemia, such as heart rate and urine output, is essential to recognize inadequate perfusion and potential hypovolemic shock.
Choice A rationale
Normal adult respirations range from 12 to 20 breaths per minute. A pulse of 60 bpm is at the low end of the normal range of 60 to 100 bpm, which does not suggest hypovolemic shock.
Choice B rationale
A temperature of 98.4 F is within the normal range of 97 F to 99 F. While a pulse of 106 bpm is slightly tachycardic, it is not a definitive indicator of critical fluid deficit.
Choice C rationale
A blood pressure of 92/60 mm Hg is borderline low, but a pulse of 100 bpm is at the upper limit of normal. These findings are less concerning than those indicating direct organ hypoperfusion.
Choice D rationale
Tachycardia of 130 bpm and urine output below 30 mL/hr signify inadequate fluid resuscitation. Normal urine output is at least 0.5 mL/kg/hr, or 30 mL/hr, indicating decreased renal perfusion and significant hypovolemia in burn patients.
Correct Answer is ["A","B","C","E"]
Explanation
End-of-life care focuses on communication, psychological support, and advocacy. Knowledge of therapeutic communication and the stages of grief is required to provide holistic care that empowers the family while reducing the uncertainty and helplessness often associated with terminal illness.
Choice A rationale
Clarifying rationale reduces anxiety by providing the family with an understanding of how pain management promotes comfort. Knowledge of pharmacokinetics helps families accept that scheduled dosing prevents breakthrough pain, reducing their stress regarding the dying process.
Choice B rationale
Using the teach-back method ensures that the family accurately understands the complex medical information provided. This reduces frustration caused by misunderstandings or the cognitive impairment often associated with high stress and emotional exhaustion during terminal care.
Choice C rationale
Transparency regarding delays prevents feelings of neglect or abandonment. Explaining the medical reasoning behind schedule changes builds trust and ensures the family feels respected and involved in the care planning process during a vulnerable time.
Choice D rationale
Limiting interactions can make a family feel isolated or ignored during a crisis. While privacy is important, the nurse must remain available and present, as social isolation often increases the stress and fear associated with death.
Choice E rationale
Providing unlimited access to staff addresses the unpredictability of terminal illness and the family's need for reassurance. This support system minimizes frustration by ensuring that questions and physiological changes are addressed promptly by the healthcare team.
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