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A client diagnosed with hyperthyroidism has been prescribed propylthiouracil. After administering the drug, the nurse would assess the client for which of the following?
- A. Skin rash
- B. Tachycardia
- C. Nervousness
- D. Constipation
Correct Answer: A
Rationale: The adverse reactions to propylthiouracil include paresthesias, numbness, headache, skin rash, nausea, vomiting, and agranulocytosis. The nurse need not observe for tachycardia, nervousness, and constipation as adverse reactions associated with propylthiouracil. Tachycardia, nervousness, and vomiting are the adverse reactions associated with the thyroid hormone levothyroxine sodium \left(\mathrm{T}_4\right).
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During ongoing assessment the nurse should observe a client taking levothyroxine for which of the following indicating a therapeutic response? Select all that apply.
- A. Weight loss
- B. Mild diuresis
- C. Increased appetite
- D. Increased mental activity
- E. Decreased pulse rate
Correct Answer: A,B,C,D
Rationale: Signs of therapeutic response to levothyroxine include weight loss; mild diuresis; increased appetite; increased pulse rate; decreased puffiness of face, hands, and feet; and client report of increased mental activity and increased sense of well-being.
A nurse is caring for a client with thyroid storm. Which of the following would the nurse expect to assess?
- A. Memory impairment
- B. Cold intolerance
- C. Constipation
- D. Altered mental status
Correct Answer: D
Rationale: A severe form of hyperthyroidism called thyroid storm is characterized by high fever, extreme tachycardia, and altered mental status. The nurse need not observe for memory impairment, cold intolerance, or constipation as characteristics of thyroid storm. Memory impairment, cold intolerance, and constipation are the manifestations of myxedema, which is a severe form of hypothyroidism.
A nurse completing a preadministration assessment on a 70-year-old client prior to the administration of levothyroxine may confuse which of the following symptoms of hypothyroidism with which symptoms associated with the aging process? Select all that apply.
- A. Constipation
- B. Confusion
- C. Unsteady gait
- D. Decreased visual acuity
- E. Cold intolerance
Correct Answer: B,C,E
Rationale: The symptoms of hypothyroidism may be confused with symptoms associated with aging, such as depression, cold intolerance, weight gain, confusion, or unsteady gait.
A nurse is preparing to administer the thyroid hormone replacement drug levothyroxine to a client. The nurse understands which of the following about this drug? Select all that apply.
- A. Equivalent to all other thyroid hormone replacement drugs
- B. More uniform potency than other thyroid hormone replacement drugs
- C. Twice-daily dosing necessary
- D. Relatively inexpensive
- E. Less frequent lab monitoring required
Correct Answer: B,D
Rationale: The following is true of the thyroid hormone replacement drug levothyroxine: it is relatively inexpensive, requires once-daily dosing, and has a more uniform potency than do other thyroid hormone replacement drugs.
The nurse should monitor a client receiving radioactive iodine \left({ }^{131} \mathrm{I}\right) for which of the following severe reactions? Select all that apply.
- A. Agranulocytosis
- B. Exfoliative dermatitis
- C. Hypoprothrombinemia
- D. Seizures
- E. Stroke
Correct Answer: A,B,C
Rationale: The nurse should monitor a client receiving radioactive iodine (I-131) for severe reactions including agranulocytosis, exfoliative dermatitis, hypoprothrombinemia, and granulocytopenia.