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Nursing-Short Answer Questions

Nursing-Short Answer Questions

Sample Answer 

Nursing-Short Answer Questions

Myxedema Coma

What Should The Nurse Expect To Find During The Assessment?

The clinical finding of myxedema is low blood pressure, bradycardia, peri-orbital puffiness, abdominal distension, and cold extremities with non-pitting oedema. The patient is confused with slow speech and reduced reflexes.

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Diagnostic investigations are thyroid function test, random serum cortisol levels, complete blood count, random blood sugar, and renal function test.

What Is The Appropriate Treatment?

Treatment method includes hormone replacement therapy, glucocorticoid therapy, and supportive measures. Hormone replacement therapy involves giving intravenous levothyroxine 300-600mcg loading dose followed by 50mcg intravenously once daily (Munir, A. 2018). Glucocorticoid therapy involves giving hydrocortisone 100mg three times a day. Supportive measures involve correcting hypothermia, hypoglycemia, and hypotension.

Complication presentations And Intervention

Complications of myxedema present with respiratory failure, gastrointestinal bleeding, myocardial infarction, heart failure, and sepsis. Complication interventions include supportive care

Thyroid Storm

What Should The Nurse Expect To Find During The Assessment?

Upon clinical assessment, the patient is confused, in hyperreflexia, tremors, or coma. The patient presents with profuse sweating, fever between 38 and 40 degrees Celcius, hypertension with wide pulse pressure, tachycardia, and respiratory distress.

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Laboratory studies necessary are thyroid function test, complete blood count, liver function test, blood gas analysis, urinalysis, and electrolytes (Akamizu, T. 2018).

What Is The Appropriate Treatment?

Treatment of thyroid storm involves supportive measures, antiadrenergic medicine, thionamides, iodine preparations, glucocorticoids, and treating the underlying condition.

Complication presentations And Intervention

The complication of thyroid storm presents with cardiac arrhythmias, deliriums and seizures, high output cardiac failure, diarrhoea, vomiting, jaundice, elevated liver enzymes, and abdominal pain. Complications interventions involve treatment of the presenting symptoms and close monitoring of the patient.

Hypoparathyroidism / Hypocalcemia

What Should The Nurse Expect To Find During The Assessment?

Hypoparathyroidism presents with chvostek sign (facial twitching induced by gently tapping the nerve), trousseau sign (carpal spasms induced by inflating blood pressure cuff around the arm), confusion, hallucination, and spastic paraplegia (Win et al., 2017).

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Laboratory investigations include blood gas analysis, electrolyte levels, liver function tests, and serum parathyroid hormone concentration.

What Is The Appropriate Treatment?

Hypoparathyroidism is managed by the use of activated vitamin D analogs and calcium supplements. Vitamin D supplements are given daily at a dose of 400-800IU.

Complication presentations And Intervention

The complication of hypoparathyroidism is acute hypocalcemia, whose Intervention is administering 3g of 10% calcium gluconate.

Hyperparathyroidism

What Should The Nurse Expect To Find During The Assessment?

Clinical presentations for hyperparathyroidism include neuropsychiatric symptoms like depression, impaired concentration, memory loss, anxiety, muscle weakness, and parathyroid mass (Kuo et al., 2019).

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Laboratory investigations done for diagnosis are serum vitamin D levels, serum parathyroid hormone levels, and serum albumin and calcium levels.

What Is The Appropriate Treatment?

Treatment modality is through estrogen replacement and Parathyroidectomy.

Complication presentations And Intervention

The common complication of hyperparathyroidism is nephrolithiasis, which is prevented by estrogen therapy and Parathyroidectomy.

DKA-Type 1 DM

What Should The Nurse Expect To Find During The Assessment?

Clinical presentations of diabetes keto-acidosis are tachypnea, tachycardia, Kussmaul breathing, dehydration, acetone smell, epigastric tenderness, and altered mental status.

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Laboratory studies done in the diagnosis of DKA are random blood sugar, urinalysis, complete blood count, electrocardiogram, blood gas analysis, electrolytes, and glycated haemoglobin levels (Alois & Rizzolo 2017).

What Is The Appropriate Treatment?

Treatment for DKA involves the administration of fluids (normal saline), insulin, potassium replacement, and correcting acidosis.

Complication presentations And Intervention

Complications of DKA are cerebral oedema. It presents with deteriorating mental status and is treated by the use of mannitol.

HHS-Type 2 DM

What Should The Nurse Expect To Find During The Assessment?

HHS stands for the hyperosmolar hyperglycemic state. It is a complication of type two diabetes. The main cause of HHS is an acute infection. It presents with dehydration, drowsiness, and tachypnea (Nysten et al, 2020).

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Important laboratory studies are random blood sugar, haemoglobin A1C, serum osmolarity, electrolyte levels, urinalysis, blood gas analysis, complete blood count, and renal function test. What Is The Appropriate Treatment?

The hyperosmolar hyperglycemic state is treated by insulin administration and fluids (normal saline).

Complication presentations And Intervention

Complications are electrolyte disturbances such as hypokalemia. It is managed by regular monitoring of electrolytes during fluid replacement therapy.

Cushing Syndrome

What Should The Nurse Expect To Find During The Assessment?

Clinical presentations of Cushing syndrome are moon face appearance, increased fat deposit, hirsutism, muscle weakness, purplish abdominal striae, and thinning of the skin.

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Important laboratory studies are 24 hours of urine-free cortisol and serum ACTH levels.

What Is The Appropriate Treatment?

Treatment of Cushing syndrome involves tapering of exogenous steroids and giving oral medications such as pasireotide, cabergoline, and mifepristone (Tatsi et al., 2020).

Complication presentations And Intervention

Complicated Cushing syndrome presents with osteoporosis, diabetes type two, hypertension, and peptic ulcer disease. The Intervention of the complications involves controlling cortisol levels, blood sugars, and blood pressure.

Addisonian Crisis

What Should The Nurse Expect To Find During The Assessment?

Addisonian crisis is an endocrine disorder characterized by adrenal hormone deficiency. It is also known as adrenal insufficiency or adrenal crisis. The primary cause of Addisonian syndrome is autoimmune adrenalitis leading to deprived production of cortisol hormone. Clinical presentations are altered mental status, hypotension, hyperreflexia, hyperpyrexia, and cyanosis.

What Diagnostic/Lab Studies Assist In Confirming The Diagnosis?

Laboratory studies done are electrolyte levels, ACTH levels, random blood sugar, and ECG (Rathbun & Singhal 2020).

What Is The Appropriate Treatment?

Addisonian crisis is treated by giving dexamethasone bolus IV 4mg, then hydrocortisone 50mg every 6 hours.

Complication presentations And Intervention

Addisonian crisis complications present with cardiac arrest, arrhythmias, hypotension, and hypoglycemia. Interventions are close monitoring of the patient’s vitals and intensive care.

References

Akamizu, T. (2018). Thyroid storm: a Japanese perspective. Thyroid28(1), 32-40.

Alois & Rizzolo (2017). Diabetic ketoacidosis: Heralding type 1 diabetes in children. Journal of the American Academy of PAs30(7), 20-23.

Kuo, E. J., Al-Alusi, M. A., Du, L., Shieh, A., Livhits, M. J., Leung, A. M., & Yeh, M. W. (2019). Surgery for primary hyperparathyroidism: adherence to consensus guidelines in an academic health system. Annals of Surgery269(1), 158-162.

Munir, A. (2018). Myxedema coma. Journal of Ayub Medical College Abbottabad30(1), 119-120.

Nysten, C., Vanhee, A., Govaerts, A., & Demeestere, J. (2020). Ocular flutter and myoclonus in the hyperosmolar hyperglycemic state. Acta Neurologica Belgica, 1-2.

Rathbun & Singhal (2020). Addisonian crisis. StatPearls [Internet].

Tatsi, C., Flippo, C., & Stratakis, C. A. (2020). Cushing syndrome: old and new genes. Best Practice & Research Clinical Endocrinology & Metabolism, 101418.

Win, M. A., Thein, K. Z., Qdaisat, A., & Yeung, S. C. J. (2017). Acute symptomatic hypocalcemia from immune checkpoint therapy-induced hypoparathyroidism. The American journal of emergency medicine35(7), 1039-e5.

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Question 


Nursing-Short Answer Questions

short answer questions on the following points

  • Goiter (hypothyroidism) = myxedema coma
  • Thyroiditis (hyperthyroidism) – thyroid storm
  • Thyroidectomy (hypoparathyroidism) – hypocalcemia
  • Hyperparathyroidism – hypercalcemia
  • Type 1 DM – DKA
  • Type 2 DM – HHS
  • Cushing syndrome –
  • Addison disease – Addisonian crisis

    Nursing-Short Answer Questions

    Nursing-Short Answer Questions

QUESTIONS:

  1. What should the nurse expect to find during the assessment?
  2. What diagnostic/lab studies assist in confirming the diagnosis?
  3. What is the appropriate treatment?
  4. What do findings tell the nurse that a complication is occurring?
  5. What is the intervention if the client develops a complication?

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