A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching?
Increase carbohydrate intake.
Decrease protein intake.
Increase intake of calcium and vitamin D.
Limit intake of potassium-rich foods.
The Correct Answer is C
Rationale:
A. Increasing carbohydrate intake is not recommended for clients with Cushing's disease as they are already at risk for hyperglycemia and weight gain due to the effects of excess cortisol.
B. Decreasing protein intake is not advisable because clients with Cushing's disease often suffer from muscle wasting and weakness. Adequate protein is necessary to help maintain muscle mass.
C. Clients with Cushing's disease should increase their intake of calcium and vitamin D because they are at risk for osteoporosis due to the effects of chronic corticosteroid exposure, which can lead to decreased bone density.
D. Clients with Cushing's disease often experience hypokalemia (low potassium levels), so limiting potassium-rich foods would not be beneficial. Instead, they should ensure adequate potassium intake.
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Correct Answer is B
Explanation
Rationale:
A. Exophthalmos is typically associated with hyperthyroidism, particularly in Graves' disease, and is not a characteristic finding in hypothyroidism.
B. Weight gain is a common symptom of hypothyroidism due to the slowed metabolism caused by reduced thyroid hormone levels. Clients often report unexplained weight gain despite maintaining a normal diet and activity level.
C. Diaphoresis, or excessive sweating, is more commonly associated with hyperthyroidism, where increased metabolism leads to heat intolerance and sweating.
D. Palpitations are also more commonly associated with hyperthyroidism, where an increased heart rate and heightened sensitivity to adrenaline are common. In hypothyroidism, bradycardia or a slowed heart rate may be observed instead.
Correct Answer is A
Explanation
Rationale:
A. Airway patency is the highest priority following a thyroidectomy due to the risk of airway obstruction from swelling or hematoma formation near the surgical site. Compromised airway can lead to respiratory distress and requires immediate attention.
B. While monitoring temperature is important for detecting potential infections, it is not the immediate priority.
C. Pain control is important for comfort and recovery, but it is not life-threatening.
D. Urination should be monitored postoperatively, but it is not as critical as ensuring a patent airway.