In adrenal insufficiency, the client has hyperkalemia due to reduced aldosterone secretion.

Option B: BUN increases as the glomerular filtration rate is reduced. BUN is handled primarily by glomerular filtration with little or no renal regulation or adaptation in the course of declining renal function, they essentially reflect GFR.
Option C: Hyponatremia is caused by reduced aldosterone secretion. Aldosterone deficiency causes hyponatremia through two mechanisms: the increased levels of ADH and subsequent upregulation of aquaporin-2 water channels in the renal tubules, and the extracellular volume depletion-induced reduction in glomerular filtration rate.
Option D: Reduced cortisol secretion leads to impaired gluconeogenesis and a reduction of glycogen in the liver and muscle, causing hypoglycemia.

To reduce water retention in a client with SIADH, the nurse should restrict fluids.

Option A: Rapid infusion of IV fluids would further increase the client’s overload.
Option B: The client should be instructed to restrict his fluid intake. It is also important to restrict sodium intake because higher correction rates have been associated with osmotic demyelination.
Option D: Administering fluids by any route would further increase the client’s already heightened fluid load.

Because some of the glucose in the bloodstream attaches to some of the hemoglobin and stays attached during the 120-day lifespan of red blood cells, glycosylated hemoglobin levels provide information about blood glucose levels during the previous 3 months.

Option A: Urine glucose levels only show the glucose levels in the urine at that specific time.
Option B: Fasting blood glucose only gives information about glucose levels at the point in time when they were obtained.
Option C: Serum fructosamine levels provide information about blood glucose control over the past 2 to 3 weeks.

NPH is an intermediate-acting insulin that peaks 8 to 12 hours after administration. Because the nurse administered NPH insulin at 7 a.m., the client is at greatest risk for hypoglycemia from 3 p.m. to 7 p.m.

Option A: At 10:00 am, the insulin given would not have reached its peak.
Option B: During noontime, risk for hypoglycemia would still be low.
Option D: 10:00 pm is already a late time for the peak action of insulin.

The adrenal glands have two divisions, the cortex, and medulla. The cortex produces three types of hormones: glucocorticoids, mineralocorticoids, and androgens.

Option B: Epinephrine, which is a catecholamines, is produced in the medulla. It causes smooth muscle relaxation in the airways or contraction of the smooth muscle in arterioles, which results in blood vessel constriction in kidneys, decreasing or inhibiting blood flow to the nephrons.
Option C: Catecholamines are produced in the medulla. They help the body respond to stress or fright and prepare the body for “fight-or-flight” reactions.
Option D: The medulla produces catecholamines — epinephrine and norepinephrine.