Safe and Effective Care Environment Q 2
The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?
A. The client with Cushing’s disease
B. The client with diabetes
C. The client with acromegaly
D. The client with myxedema
Correct Answer: A. The client with Cushing’s disease
The client with Cushing’s disease has adrenocortical hypersecretion. This increase in the level of cortisone causes the client to be immunosuppressed. High cortisol levels also cause immune disruptions; this hormone leads to a decrease in lymphocyte levels and increases the neutrophils. It causes detachment of the marginating pool of neutrophils in the bloodstream and increases the circulating neutrophil levels although there is no increased production of the neutrophils.
Option B: The client with diabetes poses no risk to other clients. Hyperglycemia alone can impair pancreatic beta-cell function and contributes to impaired insulin secretion. Consequently, there is a vicious cycle of hyperglycemia leading to the impaired metabolic state. Blood glucose levels above 180 mg/dL are often considered hyperglycemic in this context, though because of the variety of mechanisms, there is no clear cutoff point.
Option C: The client has an increase in growth hormone and poses no risk to himself or others. The common effect of the abnormal rise in growth hormone is the production of IGF-1 from the liver. The effect of IGF-1 on body tissues results in the multisystemic manifestation of acromegaly. IGF-1 also known as somatomedin C, is encoded by the IGF-1 gene on chromosome 12q23.2.
Option D: The client has hypothyroidism or myxedema and poses no risk to others or himself. Thyroid hormone influences virtually all cells in the body by activating or repressing a variety of genes after binding to thyroid hormone receptors. Ninety percent of the intracellular thyroid hormone that binds to and influences cellular function is T3, which has been converted from T4 by the removal of an iodide ion.