Author Question: Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, ... (Read 97 times)

crobinson2013 · **on:** Jun 25, 2018

Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, a 51-year-old female client has been diagnosed with a primary adrenal cortical insufficiency. Which of the following health consequences would be attributa

Which of the following health consequences would be attributable to her low levels of cortisol?
A)
Visible exophthalmos
B)
Impaired immunological and inflammatory response
C)
Diminished secondary sex characteristics
D)
Insufficient regulation of serum potassium and sodium levels

Question 2

A number of clients on a geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the last several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case.

The care team in the unit would recognize that which of the following factors likely contributed to the health problem and would anticipate which of the following treatments?
A)
The use of broad-spectrum antibiotics likely played a role in the development of infections, and most clients would likely receive metronidazole as a treatment.
B)
Genetic predisposition and the presence of the bacterium in clients' normal flora likely contributed, and treatment would consist of broad-spectrum antibiotics.
C)
Poor hand washing practice on the part of care providers led to the outbreak, and treatment will consist of hydration and nutritional support.
D)
Ingestion of contaminated food probably contributed to the infections, and corticosteroids will be needed to treat them.

Joy Chen · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Ans:
B

Feedback:

Cortisol plays a central role in the normal functioning of the immune response and inflammation. Exophthalmos is associated with Graves disease, and secondary sex characteristics are functions of adrenal androgens. Potassium and sodium are regulated by mineralocorticoids.

Answer to Question 2

Ans:
A

Feedback:

Elimination of the normal intestinal flora by broad-spectrum antibiotics commonly precedes infection by C. difficile, and metronidazole is the normal treatment. Neither genetic predisposition nor ingestion of contaminated food is a likely factor. While poor hand hygiene can spread the bacteria, treatment for C. difficile necessitates antibiotics and not simply hydration and nutritional support. The treatment of C. difficile is with antibiotics. Metronidazole is the drug of choice with vancomycin, being reserved for people who cannot tolerate metronidazole. Corticosteroids will not kill the bacterium.