Author Question: After receiving change-of-shift report about the following four patients, which patient should the ... (Read 34 times)

123654777 · **on:** Jun 25, 2018

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

a. A 31-year-old female with Cushing syndrome and a blood glucose level of 244 mg/dL
b. A 70-year-old female taking levothyroxine (Synthroid) who has an irregular pulse of 134
c. A 53-year-old male who has Addison's disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef).
d. A 22-year-old male admitted with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 130 mEq/L

Question 2

Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)?

a. The patient has a recent weight gain of 9 lb.
b. The patient complains of dyspnea with activity.
c. The patient has a urine specific gravity of 1.025.
d. The patient has a serum sodium level of 118 mEq/L.

okolip · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
Initiation of thyroid replacement in older adults may cause angina and cardiac dysrhythmias. The patient's high pulse rate needs rapid investigation by the nurse to assess for and intervene with any cardiac problems. The other patients also require nursing assessment and/or actions but are not at risk for life-threatening complications.

Answer to Question 2

ANS: D
A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and needs rapid correction. The other data are not unusual for a patient with SIADH and do not indicate the need for rapid action.