A middle-aged woman has acromegaly as a result of a pituitary ...

[tiara099]

A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager.
 
  The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which of the following results?
  A)
  The glucoses load will suppress GH level.
  B)
  The growth hormone level will not be suppressed following glucose load.
  C)
  The glucose load will raise her serum glucose level to the point of requiring insulin.
  D)
  There will be no change in the serum growth hormone level following the glucose load.

Question 2

A 20-year-old male who is addicted to crystal methamphetamine has been admitted to a hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food intake.
 
  Which of the following treatment plans would the care team most likely favor?
  A)
  Intravenous infusion of albumin coupled with vitamin supplementation
  B)
  Total parenteral nutrition
  C)
  Incrementally feeding combined with vitamin and mineral supplementation
  D)
  Rapid administration of normal saline and carbohydrates

[enass]

Answer to Question 1

Ans:
B

Feedback:

When a GH-secreting tumor is suspected, the GH response to a glucose load is measured as part of the diagnostic workup. Normally, a glucose load would suppress GH levels. However, in adults with GH-secreting tumors (acromegaly), GH levels are not suppressed (and paradoxically increase in 50 of cases) to a glucose load.

Answer to Question 2

Ans:
C

Feedback:

Slow administration of protein and calories combined with mineral and vitamin supplementation is important in the treatment of protein-calorie malnutrition. Albumin transfusions and total parenteral feeding would likely not be necessary, and rapid administration of fluids and carbohydrates may precipitate congestive heart failure.