Homework #8 Questions Name___________________________________

ESSAY. Write your answer in 1-2 paragraphs. 1) Mrs. James appeared at the clinic complaining of extreme nervousness and sweating, saying that she could feel and hear her heart thumping when she tried to sleep at night. Laboratory testing revealed hyperglycemia and increased basal metabolic rate. Although she also proved to have high blood pressure, tests of thyroid function were normal. What is your diagnosis? What treatment should be used? 2) Mr. Sanchez makes an appointment to see his doctor for pain in his abdominal area. Tests and X rays reveal kidney stones as well as bones with a moth-eaten appearance. Further questioning reveals a medical history of abnormal reexes and weakness. What is the problem and what treatment would be recommended? 3) It was often rumored that one of our deceased presidents was suffering from Addison's disease (inadequate synthesis of mineralocorticoids and glucocorticoids). What symptoms may have led to the diagnosis of this condition? 4) Due to a recent head injury, a client is told that his pituitary is hypersecreting prolactin. Is there need for concern about this young man? 5) The parents of a 17-year-old boy are concerned about his height because he is only 5 feet tall and they are both close to 6 feet tall. After tests by their doctor, certain hormones are prescribed for the boy. What is the probable diagnosis, and what hormones were prescribed? Why might the child still expect to reach his growth potential? 6) John is a 26-year-old man who begins to notice a progressive enlargement of feet, hands, cranium, nose, and lower jaw bone. His doctor recommends irradiation of the pituitary gland. What is the most likely diagnosis? Why? 7) A 25-year-old male was admitted to the medical/surgical unit with a blood glucose of 600 mg/dl. On assessment, the nurse observed his breathing was deep and rapid, and his breath smelled of acetone. His face was ushed and his skin was dry. His pH was low. Describe the physiological response that is occurring. 8) Explain how antidiuretic hormone can help regulate an abnormal increase in solute concentration in the extracellular uid. 9) What is the most important nursing intervention when caring for a patient with Cushing's syndrome?

Answer Key Testname: CLASS 8 HOMEWORK

1) The diagnosis is hypersecretion of catecholamines, sometimes arising from a rare chromafn cell tumor called a pheochromocytoma. Treatment is removal of the tumor and/or irradiation of the adrenal medulla.
ID: hap7 16.5-1 Page Ref: 632

6) The diagnosis is acromegaly. The condition results from excess secretion of growth hormone from the pituitary gland postpuberty and after the epiphyseal plates of the long bones have fused.
ID: hap7 16.5-6 Page Ref: 615

2) The problem is hyperparathyroidism resulting from a parathyroid gland tumor. The treatment is removal of the tumor.
ID: hap7 16.5-2 Page Ref: 625

3) Hypoglycemia, a bronzing of the skin, low body weight, low plasma glucose and sodium levels, high potassium levels, hypotension, and some dehydration would all have been observed in the patient.
ID: hap7 16.5-3 Page Ref: 630

7) In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites rise dramatically. The fatty acid metabolite, collectively called ketones, are strong organic acids. When they accumulate faster than they are used or excreted, the blood pH drops resulting in ketoacidosis, and ketones begin to spill into the urine. The nervous system responds by initiating rapid deep breathing to blow off carbon dioxide from the blood and increase pH.
ID: hap7 16.5-9 Page Ref: 634

4) Yes; there should be great concern, because hypersecretion of prolactin will lead to impotence.
ID: hap7 16.5-4 Page Ref: 616

5) The diagnosis is insufcient growth hormone. The prescription is commercial pituitary growth hormone. The reason the child might reach his growth potential is that the epiphyseal plates of the long bones have not yet closed, allowing additional growth of the long bones.
ID: hap7 16.5-5 Page Ref: 615-616

8) The release of antidiuretic hormone can regulate an increase in solute concentration by causing reabsorption of water by the kidney. With reabsorption, blood water volume increases, decreasing solute concentration.
ID: hap7 16.5-7 Page Ref: 617-620

9) Because of enhanced anti-inammatory effects, infections may become overwhelmingly severe. Therefore the nurse should protect the client from infection.
ID: hap7 16.5-8 Page Ref: 629-630