The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune disease. What effects does the nurse expect this therapy to have on this client's circulating levels of ACTH and aldosterone?
A. Increased ACTH, increased aldosterone
B. Increased ACTH, decreased aldosterone
C. Decreased ACTH, increased aldosterone
D. Decreased ACTH, decreased aldosterone
D
Taking exogenous cortisol increases the blood levels of cortisol, causing the negative feedback loops to be inhibited. The elevated cortisol levels will suppress hypothalamic secretion of corti-cotropin-releasing hormone (CRH). Low levels of CRH suppress the anterior pituitary production of adrenocorticotropic hormone (ACTH). Elevated blood levels of cortisol cause increased sodium retention and water reabsorption, inhibiting aldosterone synthesis.
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The scope of practice for an advanced practice psychiatric nurse adds which interventions beyond the basic level? You may select more than one answer
a. Perform mental health assessment interviews b. Prescribe psychotropic medication c. Establish therapeutic relationships d. Consultation with other clinicians e. Psychotherapy
The nurse can cease CPR when there is:
1. spontaneous breathing and absence of dyspnea. 2. spontaneous breathing and absence of cyanosis. 3. heartbeat and spontaneous breathing. 4. heartbeat and return of consciousness.
The pilot balloon on the endotracheal tube of a client being mechanically ventilated is deflated. What is the nurse's priority action?
a. Nothing; this is required during ventila-tion. b. Inflate the cuff using minimal leak tech-nique. c. Call the Rapid Response Team. d. Increase the tidal volume.
The nurse is reviewing risk factors for bladder infections with a female patient. Which patient statement indicates that teaching has been effective?
A. Females urinate more frequently than males, increasing risk. B. The urinary meatus in females is closer to the bladder than in most males. C. The urinary meatus in females is farther from the anus than most males. D. The pH of the female urethra is more conducive to infection.