The nurse assessing a client hospitalized with a diagnosis of hypoparathyroidism notes positive Trousseau's and Chvostek's signs. The nurse determines that these findings most indicate which electrolyte imbalance?
Hypernatremia
Hypermagnesemia
Hypocalcemia
Hypokalemia
The Correct Answer is C
Rationale:
A. Hypernatremia, an elevated sodium level, does not cause Trousseau's or Chvostek's signs.
B. Hypermagnesemia, an elevated magnesium level, is not associated with positive Trousseau's and Chvostek's signs.
C. Hypocalcemia, a low calcium level, is commonly associated with positive Trousseau's and Chvostek's signs. Trousseau's sign is a carpopedal spasm induced by inflating a blood pressure cuff, while Chvostek's sign is facial twitching in response to tapping over the facial nerve. Both are indicative of neuromuscular irritability due to low calcium levels.
D. Hypokalemia, a low potassium level, does not cause these specific signs and is associated with different clinical manifestations.
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Correct Answer is ["A","B","D","E"]
Explanation
Rationale:
A. Purple striae (stretch marks) are common in Cushing's syndrome due to skin thinning and the redistribution of fat.
B. A "moon face" is a classic sign of Cushing's syndrome, caused by fat deposition in the face.
C. Bronze pigmentation is associated with Addison's disease, not Cushing's syndrome.
D. A "buffalo hump," or fat accumulation on the upper back, is another characteristic feature of Cushing's syndrome.
E. Poor wound healing is expected in Cushing's syndrome due to the effects of prolonged exposure to high cortisol levels, which impair immune function and tissue repair.
Correct Answer is D
Explanation
Rationale:
A. Children with Addison’s disease often require increased sodium intake, especially during periods of stress or illness, due to the lack of aldosterone.
B. Addison's disease typically causes fluid volume deficit rather than excess.
C. Addison's disease is more commonly associated with hypoglycemia rather than hyperglycemia.
D. Teaching the parents about cortisol replacement therapy is crucial, as this is the primary treatment for managing Addison’s disease. The child will need lifelong hormone replacement to compensate for the lack of cortisol.