Adult Health Nursing Flashcards

A patient has been diagnosed with Cushing's syndrome. Which assessment finding is expected?

Answer: Moon face, central obesity, and purple striae

Cushing's syndrome results from chronic cortisol excess. Classic findings include moon-shaped face (fat redistribution), central obesity with thin limbs, buffalo hump, purple striae (stretch marks from skin fragility), hypertension, and hyperglycemia.

What is the primary nursing concern for a patient with liver cirrhosis and ascites?

Answer: Risk of spontaneous bacterial peritonitis and fluid/electrolyte imbalance

Ascites in cirrhosis creates a large reservoir of stagnant fluid at risk for bacterial infection (spontaneous bacterial peritonitis). Additionally, portal hypertension causes sodium/water retention and electrolyte imbalances, particularly hyponatremia and hypokalemia.

A patient with hyperthyroidism is preparing for a thyroidectomy. Which pre-operative medication is given to reduce thyroid vascularity?

Answer: Lugol's iodine solution

Lugol's iodine solution (potassium iodide) is given 10–14 days pre-operatively to reduce thyroid vascularity and gland size, decreasing intraoperative hemorrhage risk. Propylthiouracil blocks hormone synthesis, and propranolol controls tachycardia.

Which finding is a classic early sign of increased intracranial pressure (ICP)?

Answer: Decreased level of consciousness and restlessness

Early ICP elevation manifests as subtle changes: restlessness, slight confusion, drowsiness, and irritability. Cushing's triad and fixed dilated pupils are late signs indicating herniation and impending brain death.

A patient is receiving total parenteral nutrition (TPN). What is the most important nursing action?

Answer: Monitor blood glucose every 4–6 hours and assess for infection at the catheter site

TPN is glucose-rich and delivered through a central line, creating dual risks: hyperglycemia (requiring regular glucose monitoring) and catheter-related bloodstream infection (requiring strict aseptic technique and site assessment).

Which electrolyte imbalance most commonly causes muscle cramps and tetany?

Answer: Hypocalcemia

Hypocalcemia causes increased neuromuscular excitability, manifesting as muscle cramps, tetany, positive Trousseau's and Chvostek's signs, and in severe cases, laryngospasm and seizures. Calcium is essential for normal muscle and nerve function.