The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?
Pain 7/10 at the surgical site
Hyperglycemia
Blood pressure 92/50
Sodium 152 mEq/L
The Correct Answer is C
A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.
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Related Questions
Correct Answer is D
Explanation
A. Ataxic dysarthria: This is not a common complication associated with Cushing syndrome. It is more related to neurological disorders affecting speech and coordination.
B. Hypotension: Cushing syndrome typically causes hypertension rather than hypotension due to fluid retention and increased vascular resistance.
C. Hyperkalemia: Cushing syndrome is associated with hypokalemia rather than hyperkalemia due to the effects of excess cortisol on potassium levels.
D. Bone fracture: Cushing syndrome increases the risk of osteoporosis and bone fractures due to prolonged exposure to high levels of cortisol, which affects bone density and strength.
Correct Answer is B
Explanation
A. "You may need to repeat this therapy again in three weeks if the first dose doesn't achieve optimal results": Radioactive iodine therapy may require additional doses, but this is not determined by a set timeframe such as three weeks. The need for additional therapy is based on the individual’s response and thyroid function tests.
B. "Avoid being close to pregnant women and children for 7 days after your treatment": This is correct as radioactive iodine therapy can emit radiation, and avoiding close contact with vulnerable populations such as pregnant women and children helps minimize their exposure to radiation.
C. "You may need to begin corticosteroid replacement therapy after this treatment": This is incorrect because corticosteroid replacement is not typically required after radioactive iodine therapy for Graves' disease. The treatment primarily targets the thyroid gland.
D. "The purpose of this therapy is to increase your levels of thyroid hormone": This is incorrect. The purpose of radioactive iodine therapy is to reduce thyroid hormone production by destroying thyroid tissue, which helps to manage hyperthyroidism in Graves' disease.
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