The nurse is preparing a female client with Addison's disease for self-care afi.4 discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?
The drug may be needed to treat a sudden systemic allergic reaction.
Hypertensive crisis requires immediate treatment to prevent a stroke.
Hyperglycemia may require cortisol to lower the blood glucose level.
Stress increases the body's need for additional replacement hormone.
The Correct Answer is D
A) The drug may be needed to treat a sudden systemic allergic reaction:
While cortisol may play a role in managing allergic reactions by suppressing inflammation, the primary reason for carrying a cortisol kit in Addison's disease is not typically related to managing allergic reactions.
B) Hypertensive crisis requires immediate treatment to prevent a stroke:
Hypertensive crisis may occur in some individuals with Addison's disease due to adrenal insufficiency, but the immediate treatment for this would typically involve fluids and intravenous hydrocortisone rather than carrying a cortisol kit for self-administration.
C) Hyperglycemia may require cortisol to lower the blood glucose level:
Cortisol can indeed influence blood glucose levels, but the need to carry a cortisol kit is primarily related to the management of adrenal insufficiency rather than hyperglycemia alone.
D) Stress increases the body's need for additional replacement hormone:
Correct. Individuals with Addison's disease have insufficient production of cortisol and often also lack aldosterone. During times of stress, such as illness, trauma, or surgery, the body's demand for cortisol increases to help cope with the stress. Inadequate cortisol production during stress can lead to adrenal crisis, a life-threatening condition. Therefore, carrying a cortisol kit allows the individual to promptly administer additional replacement hormone (usually hydrocortisone) during times of stress to prevent adrenal crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The ABG results indicate respiratory acidosis (pH 7.0, PaCO2 66 mmHg) with compensatory metabolic alkalosis (HCO3- 24 mEq/L). The low PaO2 (60 mmHg) suggests hypoxemia.
pH 7.0: The pH is below the normal range (7.35 to 7.45), indicating acidosis.
PaCO2 66 mmHg: The PaCO2 is elevated above the normal range (35 to 45 mmHg), indicating respiratory acidosis.
HCO3- 24 mEq/L: The bicarbonate level is within the normal range (21 to 28 mEq/L), indicating compensatory metabolic alkalosis.
PaO2 60 mmHg: The PaO2 is decreased below the normal range (80 to 100 mmHg), indicating hypoxemia.
These findings suggest that the client is experiencing respiratory failure, which is characterized by inadequate gas exchange resulting in hypoxemia and hypercapnia. In this case, the massive pulmonary embolus is causing ventilation-perfusion (V/Q) mismatch, leading to impaired gas exchange and respiratory compromise. Tachycardia, hypotension, and audible bilateral pulmonary crackles further support the diagnosis of respiratory failure in the context of a massive pulmonary embolus.
Correct Answer is A
Explanation
A) Blockage of retinal capillaries causing ischemic damage of the central macular area:
Correct. Blurry central vision that worsens over time can be indicative of macular ischemia, often caused by blockage of retinal capillaries leading to ischemic damage of the central macular area. This condition can occur in diseases such as diabetic retinopathy or retinal vein occlusion.
B) Opaque spoke-like lines developing in the periphery of the lens to the center:
This description is more characteristic of cataracts, which cause visual disturbances such as glare or halos around lights rather than blurry central vision.
C) Tears in the retina that detach from the lining of the posterior eyeball:
Retinal tears and subsequent detachment can cause visual disturbances, but they typically present as sudden onset of floaters, flashes of light, and a curtain-like shadow over the visual field rather than blurry central vision.
D) An increase in intraocular pressure with loss of peripheral vision:
This description is indicative of glaucoma, which can lead to loss of peripheral vision (visual field defects) rather than blurry central vision. Glaucoma-related visual field loss usually begins peripherally and progresses inward, affecting central vision in later stages.
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