Which important teaching point should the nurse include in the ...

[londonang]

Which important teaching point should the nurse include in the plan of care for a patient diagnosed with Cushing's disease?
 
  a. Daily weight using same scale
  b. Wash hands frequently
  c. Use exfoliating soaps when bathing
  d. Avoid yearly influenza vaccine

Question 2

Following a parathyroidectomy, which electrolyte should the nurse most closely monitor?
 
  a. Potassium
  b. Sodium
  c. Magnesium
  d. Calcium

[nickk12214]

Answer to Question 1

ANS: B
Cushing's syndrome is characterized by chronic excess glucocorticoid (cortisol) secretion from the adrenal cortex. This is caused by the hypothalamus, or the anterior pituitary gland, or the adrenal cortex. Cushing's syndrome can also be caused by taking corticosteroids in the form of medication (such as prednisone) over time  referred to as exogenous Cushing syndrome. Regardless of the cause, excess secretion of cortisol has a systemic affect affecting immunity, metabolism, and fat distribution (truncal obesity), reduced muscle mass, loss of bone density, hypertension, fragility to microvasculature, as well as thinning of the skin. Washing hands is important because the patient's immune system is suppressed due to the excess glucocorticoid level. Daily weights are not indicated. Exfoliating soaps may damage thin skin. The patient should receive vaccinations due to being immunocompromised.

Answer to Question 2

ANS: D
Because the parathyroids are located on the thyroid gland, similar concerns for postoperative monitoring apply. Additionally, calcium levels are monitored to avoid hypocalcemic crisis.