Question 1 of 6
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Which clinical manifestation would alert the nurse to hypercalcemia in a patient who has hyperparathyroidism?
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- Respiratory distressRespiratory distress is not associated with hypercalcemia. Respiratory distress could be observed in myxedema (hypothyroidism).
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- Declining urine outputIncreased urine output would be typical for hypercalcemia.
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- Lethargy and confusionHyperparathyroidism can cause hypercalcemia. Signs of hypercalcemia include lethargy, confusion, muscle weakness, polyuria, constipation, and nausea and vomiting.
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- Hyperactive bowel soundsHypoactive bowel sounds, not hyperactive, would be typical for hypercalcemia.
Question 2 of 6
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Which intervention would the nurse include for an older patient diagnosed with hyperparathyroidism?
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- Teaching the patient to support the neck when movingSupporting the neck would not be necessary for this patient.
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- Instructing the patient to use a soft-bristled toothbrushUsing a soft-bristled toothbrush would not be necessary for this patient.
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- Using a lift sheet to assist the patient with position changesPatients with hyperparathyroidism have an increased risk for pathologic fractures because of high parathyroid hormones causing calcium to shift from the bones into the bloodstream. Using a lift sheet would protect the patient and reduce the risk for bone injury.
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- Straining all urine and sending stones for laboratory analysisPatients may have urinary stones because calcium levels are elevated, but stone analysis would have a lower priority (the majority of stones are usually calcium oxalate).
Question 3 of 6
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Which collaborative intervention would the nurse anticipate for an injured patient who arrived in the emergency department with a medical identification bracelet marked “Addison disease”?
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- Strict reduction of dietary sodiumThe patient with Addison disease is prone to hyponatremia and may need a high-sodium diet.
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- Increased glucocorticoid replacementThe patient with Addison disease needs lifelong glucocorticoid and mineralocorticoid replacement and has an increased need for replacement therapy with illness, injury, or stress.
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- Elimination of mineralocorticoid replacementElimination of mineralocorticoid replacement cannot occur for Addison disease.
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- Suppression of pituitary adrenocorticotropic hormone (ACTH) synthesisTreatment for Cushing syndrome, not Addison disease, includes suppression of pituitary ACTH synthesis.
Question 4 of 6
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The nurse is caring for a patient who presents to the emergency department for a severe headache and palpitations. Upon assessment, the nurse notes a blood pressure of 265/155 mm Hg. Which condition does the nurse suspect the patient has?
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- Addison diseaseSymptoms of Addison disease include hypoglycemia, muscle weakness, hypotension, and malaise.
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- HyperparathyroidismHyperparathyroidism presents with symptoms including dehydration, confusion, lethargy, and weight loss.
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- PheochromocytomaPheochromocytoma is caused by excessive catecholamine release, which can result in symptoms including headache, palpitations, and severe hypertension.
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- HypocalcemiaSymptoms of hypocalcemia include tingling, numbness, and muscle cramps.
Question 5 of 6
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Which treatment may be indicated for a patient with hyperparathyroidism? Select all that apply. One, some, or all responses may be correct.
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- Loop diureticsLoop diuretics may be used to treat hyperparathyroidism because they promote urine excretion of excess calcium.
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- AntihypertensivesAntihypertensives are not indicated for treatment of hyperparathyroidism. They are used in conditions that increase blood pressure, such as pheochromocytoma.
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- GlucocorticoidsGlucocorticoids are indicated for the treatment of Addison disease, not hyperparathyroidism.
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- Vitamin D supplementsVitamin D supplements are used to treat secondary forms of hyperparathyroidism to enhance absorption of calcium from the small intestine.
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- Phosphate replacementPhosphate replacement is indicated for patients with hyperparathyroidism because they often have hypophosphatemia.
Question 6 of 6
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Which statement would the nurse include in the patient teaching about use of corticosteroids for treatment of Addison disease?
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- “You may notice weight loss.”Weight gain, not loss, is a common side effect of steroid medications.
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- “Take oral steroids on an empty stomach.”Oral steroids should be taken with food to prevent gastric upset.
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- “You can stop taking the steroids when you start feeling better.”Steroids should not be stopped abruptly because this can cause death in a patient who has been on long-term therapy.
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- “Avoid crowds, especially during the winter months.”Steroids increase the risk for infection, so it is important for patients on steroids to avoid crowds, especially during cold and flu season.
