Med Surg Exam 3

Atrial fibrillation is a heart condition characterized by irregular and rapid heartbeats. When the heart is not pumping blood effectively, blood can pool and form clots in the atria. If a clot dislodges and travels to the brain, it can cause an ischemic stroke by blocking blood flow to a part of the brain. Therefore, atrial fibrillation increases the risk of ischemic stroke.

Graves disease is indeed an autoimmune disorder. In this condition, the immune system mistakenly attacks the thyroid gland, leading to the overproduction of thyroid hormones. This can result in symptoms such as weight loss, rapid heartbeat, and bulging eyes. The autoimmune nature of the disease means that the body's immune system is targeting its own cells and tissues, causing the dysfunction observed in Graves disease.

A paralyzed left side is associated with a right-sided stroke. This is because the brain is cross-wired, meaning that the left side of the brain controls the right side of the body and vice versa. Therefore, damage to the right side of the brain will result in paralysis on the left side of the body.

This question is asking about the type of hypothyroid category that involves the destruction of thyroid tissue and defective hormone synthesis. The correct answer is "Primary." In primary hypothyroidism, the problem originates in the thyroid gland itself, leading to reduced hormone production. This can be caused by various factors, including autoimmune diseases, radiation therapy, or surgical removal of the thyroid gland. Secondary hypothyroidism, on the other hand, occurs when the problem lies in the pituitary gland or hypothalamus, which affects the production of thyroid-stimulating hormone (TSH) and ultimately leads to decreased thyroid hormone levels.

The statement is true because the thyroid gland is highly vascularized, meaning it has a rich blood supply. This is important because the thyroid gland produces hormones that are released into the bloodstream to regulate various bodily functions. The high vascularity ensures efficient delivery of these hormones to target tissues and organs throughout the body.

Thyroxine is the most abundant hormone produced by the thyroid gland. It plays a crucial role in regulating the body's metabolism and energy levels. Triiodothyronine is another hormone produced by the thyroid gland, but it is present in smaller amounts compared to thyroxine. Therefore, thyroxine is the correct answer as it is the most abundant hormone between the two options given.

As a nurse, you should not palpate the thyroid. Palpating the thyroid requires specialized training and expertise, typically performed by a healthcare provider such as a physician or endocrinologist. The thyroid is a sensitive gland located in the neck, and improper palpation can cause discomfort or even harm to the patient. Therefore, it is important for nurses to refer patients to the appropriate healthcare professional for thyroid palpation rather than attempting it themselves.

A score of less than 9 on the Glasgow Coma Scale is considered severe. This indicates that the patient has a significantly impaired level of consciousness and may be in a critical condition. The Glasgow Coma Scale is a neurological assessment tool used to evaluate a patient's level of consciousness based on eye-opening, verbal response, and motor response. A score of less than 9 suggests a severe brain injury or impairment, requiring immediate medical attention and intervention.

A score of 9-12 on the Glasgow Coma Scale is considered moderate. This indicates that the patient has a moderate level of consciousness and may have some impairments in their neurological functioning. A score below 9 indicates severe impairment, while a score above 13 indicates mild impairment.

When calcium levels in the body are low, the parathyroid glands increase their secretion. This is because the parathyroid hormone (PTH), which is produced by the parathyroid glands, plays a crucial role in regulating calcium levels. When calcium levels drop, the parathyroid glands detect this and release more PTH into the bloodstream. PTH then acts on the bones, kidneys, and intestines to increase calcium absorption, decrease calcium excretion, and stimulate the release of calcium from bones. This helps to raise calcium levels back to normal.

Also will have increased T4 and T3

This is an example of primary hyperparathyroidism. In primary hyperparathyroidism, there is an increased secretion of parathyroid hormone (PTH), which is often caused by a benign tumor of the parathyroid gland. Secondary hyperparathyroidism, on the other hand, occurs as a result of another underlying condition, such as kidney disease. Tertiary hyperparathyroidism is a rare condition that develops after long-standing secondary hyperparathyroidism, where the parathyroid glands become hyperactive even after the underlying condition has been resolved.

Mixing long-acting insulin with other insulins is generally not recommended. Long-acting insulin is designed to provide a steady release of insulin over a long period of time, while other insulins have different durations and peak times. Mixing them together can alter their effectiveness and lead to unpredictable blood sugar levels. It is important to follow the instructions provided by healthcare professionals and use different syringes or pens for different types of insulin to ensure accurate dosing and avoid potential complications.

The given phenomenon, where blood glucose levels elevate at 5-6 a.m., is known as the dawn phenomenon. This occurs due to the release of growth hormone and cortisol during the nighttime, which in turn leads to increased insulin production. As a result, blood glucose levels rise in the early morning hours. This is different from the Somogyi effect, which involves a rebound increase in blood glucose levels after a period of hypoglycemia.

Insulin is a hormone that plays a crucial role in regulating blood sugar levels. It allows glucose, which is a type of sugar, to move from the bloodstream into the cells of the body. This process is essential for providing energy to the cells and maintaining normal blood sugar levels.

Hypothyroidism is a condition characterized by an underactive thyroid gland, which leads to decreased production of thyroid hormones. One of the primary hormones produced by the thyroid gland is TSH (thyroid-stimulating hormone). In hypothyroidism, the levels of TSH in the blood are typically elevated as the body tries to stimulate the thyroid gland to produce more hormones. Therefore, high TSH levels correlate with hypothyroidism rather than hyperthyroidism, where TSH levels would be low due to excessive thyroid hormone production.

Goiters are caused by iodine deficiency. Can result from hyperthyroidism or hypothyroidism

Radioactive iodine uptake (RAIU) is a diagnostic test that directly measures thyroid activity. It involves the administration of a small amount of radioactive iodine, which is then taken up by the thyroid gland. The amount of iodine absorbed by the thyroid is measured, providing information about its function and activity. This test is commonly used to diagnose conditions such as hyperthyroidism and to determine the cause of an enlarged thyroid gland. Blood levels, ABGs (arterial blood gases), and ultrasound are not direct measures of thyroid activity and do not provide the same level of information as RAIU.

The postictal phase refers to the period after a seizure when the individual experiences fatigue, confusion, and other physical and mental symptoms. During this phase, the brain recovers from the seizure activity and the person may feel exhausted and disoriented. The term "postictal" comes from the Latin words "post" meaning after and "ictus" meaning seizure. This phase can last anywhere from a few minutes to several hours, and sometimes even longer. It is characterized by a gradual return to normal consciousness and functioning.

Wernicke's aphasia is characterized by damage to the posterior part of the left temporal lobe. People with Wernicke's aphasia have fluent speech, but their speech may lack meaning and they may produce made-up words or nonsensical sentences. This type of aphasia is often associated with difficulty understanding language and poor language comprehension.

Weight loss is a symptom of DMT1 (Type 1 diabetes). This is because in DMT1, the body is unable to produce insulin, leading to high blood sugar levels. Without insulin, the body is unable to properly utilize glucose as an energy source, causing the body to break down fat and muscle for energy, resulting in weight loss. DMT2 (Type 2 diabetes), on the other hand, is characterized by insulin resistance, where the body's cells do not respond effectively to insulin, leading to high blood sugar levels, but weight loss is not typically a symptom of DMT2.

The phase of seizure that is being described here is the "Aural" phase. This phase is characterized by sensory warnings or sensations that occur before the seizure itself. These warnings can include things like visual disturbances, auditory hallucinations, or a sense of impending doom. It is important to note that not all individuals will experience an aural phase before a seizure, and the symptoms can vary from person to person.

The phase of seizure referred to as "Ictal" is the correct answer. The ictal phase is the actual seizure phase, characterized by the occurrence of abnormal electrical activity in the brain. During this phase, the individual experiences the seizure itself, with symptoms such as convulsions, loss of consciousness, and sensory disturbances. The ictal phase typically lasts for a short duration, usually a few minutes. It is important to differentiate the ictal phase from other phases, such as the prodromal (early warning signs), aural (sensory disturbances before the seizure), and postictal (recovery) phases.

Impaired speech, math, and language deficits are associated with left-sided stroke. The left side of the brain controls language and communication functions in most individuals, so when a stroke occurs in the left side of the brain, it can result in difficulties with speech, math, and language skills. This is because the stroke damages the areas responsible for these functions. In contrast, a right-sided stroke typically affects the left side of the body and can cause weakness or paralysis on that side, but it is less likely to impact speech and language abilities.

We need to keep blood oxygenated

When calcium levels are high, the parathyroid glands decrease their secretion. This is because the parathyroid glands are responsible for regulating calcium levels in the body. When calcium levels are already high, there is no need for the parathyroid glands to continue secreting parathyroid hormone (PTH), which helps to increase calcium levels. Therefore, the parathyroid glands decrease their secretion of PTH in order to maintain balance and prevent calcium levels from becoming too high.

Bacterial meningitis is considered the most dangerous type of meningitis because it progresses rapidly and can lead to severe complications, such as brain damage, hearing loss, and even death. Unlike viral meningitis, which is usually less severe and resolves on its own, bacterial meningitis requires immediate medical attention and treatment with antibiotics. Encephalitis, on the other hand, refers to inflammation of the brain and is a separate condition from meningitis.

Hyperparathyroidism is a condition where the parathyroid glands produce excessive amounts of parathyroid hormone (PTH), resulting in increased calcium levels in the blood. Hypercalcemia is characterized by high levels of calcium in the blood, and it is a common symptom of hyperparathyroidism. Therefore, hyperparathyroidism is associated with symptoms of hypercalcemia rather than hypocalcemia, hypermagnesemia, or hyponatremia.

Generalized seizures are characterized by abnormal electrical activity that occurs throughout the entire brain. This means that both sides of the brain are affected during a generalized seizure. Unlike focal seizures, which only affect one specific area or hemisphere of the brain, generalized seizures involve widespread electrical disturbances that can cause loss of consciousness and convulsions. Therefore, it is correct to say that both sides of the brain are affected in generalized seizures.

The correct answer is Dawn phenomenon. Dawn phenomenon refers to the natural rise in blood glucose levels that occurs in the early morning, typically between 5-6am, due to hormonal changes in the body. During this time, the liver releases stored glucose into the bloodstream, causing a spike in blood glucose levels. However, in the hours before this spike, typically between 2-4am, blood glucose levels return to normal. This pattern is characteristic of the Dawn phenomenon.

The Somogyi Effect refers to a rebound phenomenon where blood glucose levels drop during the night, typically between 2-4am, and then rise significantly by the morning. This occurs as a result of the body's response to low blood sugar levels during sleep, triggering the release of hormones that stimulate the production of glucose. The elevated glucose levels in the morning are often higher than normal, leading to a spike in blood sugar levels. This phenomenon is commonly observed in individuals with diabetes who take insulin or certain medications to manage their blood sugar levels.

The correct answer is "My BG has been with 90-100 for the past seven days." This answer indicates that the client understands a normal range of glucose levels by stating that their blood glucose (BG) has consistently been between 90-100 for the past week. This range falls within the normal range for glucose levels, indicating that the client has a good understanding of what is considered normal. The other options either indicate high or low glucose levels, which would not be considered normal.

Secondary hyperparathyroidism occurs as a compensatory response to conditions that cause hypocalcemia. In this condition, the parathyroid glands produce excessive amounts of parathyroid hormone (PTH) in an attempt to increase blood calcium levels. This can occur in response to chronic kidney disease, vitamin D deficiency, or malabsorption disorders, among other conditions. The excess PTH leads to increased bone resorption, which can cause bone pain and fractures. Treatment typically involves addressing the underlying cause and may include vitamin D and calcium supplementation.

Short attention span and impaired judgment are associated with right-sided stroke. This is because the right side of the brain controls the left side of the body and is responsible for attention and judgment. When there is damage to the right side of the brain due to a stroke, it can result in deficits in attention and judgment, leading to a short attention span and impaired judgment.

Hypoparathyroidism is uncommon.

Hypothyroidism is the correct answer because it is characterized by elevated levels of thyroid-stimulating hormone (TSH) and decreased levels of thyroxine (T4). TSH is produced by the pituitary gland to stimulate the thyroid gland to produce T4, which is the main hormone responsible for regulating metabolism. In hypothyroidism, the thyroid gland is underactive and does not produce enough T4, leading to an increase in TSH levels as the body tries to compensate for the low thyroid hormone levels.

Bacterial meningitis is considered worse than viral meningitis because it is typically more severe and can lead to more complications. Bacterial meningitis is caused by bacteria entering the bloodstream and infecting the meninges, the protective membranes surrounding the brain and spinal cord. It can progress rapidly and cause symptoms such as high fever, severe headache, stiff neck, and neurological problems. Without prompt treatment, bacterial meningitis can lead to brain damage, hearing loss, seizures, and even death. On the other hand, viral meningitis is usually less severe, with symptoms resembling a common flu and often resolving on their own without specific treatment.

Lispro is a fast-acting insulin because it is designed to be absorbed quickly into the bloodstream after injection. It starts working within 15 minutes, peaks in about 1-2 hours, and lasts for about 3-4 hours. This rapid onset and short duration make it ideal for controlling blood sugar spikes that occur after meals. Regular insulin, on the other hand, has a slower onset and longer duration, making it a short-acting insulin. NPH and Glargine are both long-acting insulins, providing a more steady and prolonged effect.

The prodromal phase of a seizure refers to the period of time before the seizure actually occurs, during which individuals may experience various sensations and behavioral changes. These can serve as warning signs or indicators that a seizure is imminent. This phase is characterized by symptoms such as mood changes, irritability, fatigue, headache, and difficulty concentrating. It is important to recognize and understand these prodromal symptoms in order to effectively manage and prepare for seizures.

Aphasia is commonly associated with a left side stroke. The left side of the brain is responsible for language processing in most individuals, so when there is damage to this side due to a stroke, it can result in difficulty with speaking, understanding language, reading, and writing. This condition is known as aphasia. On the other hand, a right side stroke typically affects other functions such as spatial awareness and visual processing.

TPA (tissue plasminogen activator) is a medication used to dissolve blood clots. Ischemic strokes occur when a blood clot blocks a blood vessel in the brain, leading to reduced blood flow and oxygen supply. Administering TPA in ischemic strokes helps to dissolve the clot and restore blood flow, potentially preventing further damage to the brain. On the other hand, hemorrhagic strokes occur when a blood vessel in the brain ruptures, causing bleeding. Administering TPA in hemorrhagic strokes can worsen the bleeding and is contraindicated. Therefore, the correct answer is ischemic.

In thyroid cancer, the thyroid gland is removed. The thyroid gland is a small butterfly-shaped gland located in the neck that produces hormones that regulate metabolism. In cases of thyroid cancer, surgical removal of the thyroid gland is often necessary to remove the cancerous cells and prevent the spread of the disease. This procedure is called a thyroidectomy. It is important to remove the thyroid gland to eliminate the source of the cancer and to prevent further complications.

Graves disease is the most common form of hyperthyroidism. It is an autoimmune disorder in which the immune system mistakenly attacks the thyroid gland, causing it to produce excessive amounts of thyroid hormones. This leads to symptoms such as weight loss, rapid heartbeat, tremors, and anxiety. The repeated mention of "Graves disease" in the answer suggests that it is the correct response.

Taping the eyes closed is an appropriate intervention for Graves disease because it helps to protect the eyes from exposure and dryness, which are common symptoms of the condition. Graves disease can cause the eyelids to retract and the eyes to bulge, leading to increased sensitivity and potential damage to the cornea. Taping the eyes closed helps to keep the eyes lubricated and prevents further irritation and complications. This intervention can provide relief and promote healing for individuals with Graves disease.

Dawn phenomenon is increased insulin with the nighttime release of growth hormone and cortisol. The BG elevates around 5-6a.m.

Metformin is classified as a biguanide. Biguanides are a type of oral medication used to treat type 2 diabetes. They work by decreasing the production of glucose in the liver and improving the body's response to insulin. Metformin is commonly prescribed as a first-line treatment for diabetes due to its effectiveness in lowering blood sugar levels and its low risk of causing hypoglycemia. Glipizide and glyburide are sulfonylureas, another class of diabetes medications, while acarbose is an alpha-glucosidase inhibitor.

Secondary hypothyroidism refers to a condition where the thyroid gland is not able to produce enough thyroid hormones due to a problem in the pituitary gland or hypothalamus. In this case, the question provides options related to causes of secondary hypothyroidism, such as pituitary disease and thyroiditis. Iodine-containing medications are not typically associated with secondary hypothyroidism. Therefore, the correct answer is secondary.

The parathyroid gland regulates calcium levels by secreting parathyroid hormone (PTH). PTH helps to increase calcium levels in the blood by stimulating the release of calcium from bones, increasing calcium reabsorption in the kidneys, and enhancing the absorption of calcium from the intestines.

Tonic-clonic seizures, also known as grand mal seizures, are the most common type of seizure. They are characterized by a sudden loss of consciousness and muscle stiffening (tonic phase), followed by rhythmic jerking movements (clonic phase). These seizures can be caused by various conditions such as epilepsy, brain injury, or withdrawal from certain medications. Tonic-clonic seizures are often dramatic and can be frightening for both the person experiencing them and those witnessing them. Treatment options include antiepileptic medications and lifestyle modifications to manage triggers and reduce the frequency of seizures.