An adolescent girl with Graves' disease is admitted to the ...

[kshipps]

An adolescent girl with Graves' disease is admitted to the hospital. The nurse expects to find which of the following clinical manifestations of Graves'disease present?
 
  1. Weight gain,hirsutism,and muscleweakness
  2. Dehydration,metabolic acidosis,andhypertension
  3. Tachycardia,fatigue,and heatintolerance
  4. Hyperglycemia,ketonuria,andglucosuria

Question 2

A child will require lifelong cortisol replacement therapy following the removal of adrenal glands. The family should be taught
 
  1. to discontinue the injections afterone week.
  2. that hydrocortisone is only availablein oral form,so the medication will need to be held if the child has nausea or vomiting.
  3. that the child should take thehydrocortisone on an empty stomach.
  4. to administer the medication early inthe morning or every other day in the a.m.

[livaneabi]

Answer to Question 1

Answer:3
Rationale:Graves'disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones.Clinical manifestations include tachycardia,fatigue,and heat intolerance. Weight gain, hirsutism,and muscle weakness are signs of Cushing's syndrome.Dehydratio n, metabolic acidosis,and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia,ketonuria,and glucosuria are signs of diabetes.

Answer to Question 2

Answer:4
Rationale: Administering the medication early in the morning or every other day causes fewer symptoms and mimics the normal diurnal pattern of cortisol secretion. The injections should not be discontinued abruptly.Injectable hydrocortisone is available and should be kept on hand if the child is unable to take the medication by mouth.Cortisone should be taken with food.