Nokea
A client is diagnosed with euthyroid goiter. The nurse would expect to administer which of the following?
- A. Levothyroxine
- B. Methimazole
- C. Propylthiouracil
- D. Sodium iodide
Correct Answer: A
Rationale: Euthyroid goiter is treated with thyroid hormones, such as levothyroxine. Methimazole, propylthiouracil, and sodium iodide are used to treat hyperthyroidism.
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When teaching a client about his prescribed levothyroxine therapy, the nurse determines that the teaching was successful when the client states that he will contact his primary health care provider if which of the following occur? Select all that apply.
- A. Constipation
- B. Palpitations
- C. Excessive diaphoresis
- D. Significant weight changes
- E. Chest pain
Correct Answer: B,C,D,E
Rationale: The client taking levothyroxine should contact his primary health care provider if any of the following occur: headache, nervousness, palpitations, diarrhea, excessive diaphoresis, heat intolerance, chest pain, increased pulse rate, significant weight changes, or any unusual physical change or event.
A nurse is caring for a client with chronic lymphocytic thyroiditis. The physician has prescribed liothyronine to the client. The nurse understands that the drug is administered cautiously to clients with which of the following?
- A. Upper respiratory tract infection
- B. Diabetes
- C. Elevated body temperature
- D. Cardiac disease
Correct Answer: D
Rationale: The nurse should be cautious about existing conditions such as cardiac disease and also cautious about factating clients before administering liothyronine to clients with chronic lymphocytic thyroiditis. The nurse need not be cautious about administering liothyronine to clients with an upper respiratory tract infection, diabetes, or elevated body temperature. The nurse should be cautious about clients contracting an upper respiratory tract infection on administrating antithyroid drugs. A client with diabetes may experience an increase in diabetes while undergoing thyroid hormone replacement therapy. The nurse should observe for elevated body temperature while managing the needs of a client administered thyroid hormones.
During initial therapy with levothyroxine, the most common reactions a nurse might observe in a client include which of the following? Select all that apply.
- A. Elevated body temperature
- B. Weight loss
- C. Tachycardia
- D. Hypotension
- E. Insomnia
Correct Answer: A,B,C,E
Rationale: During initial therapy with levothyroxine, the most common reactions a nurse would observe are signs of overdose and hyperthyroidism, which include increased metabolism; heat intolerance; elevated body temperature; weight loss; tachycardia; hypertension; nervousness; anxiety; insomnia; exophthalmos; flushed, warm, moist skin; thinning hair; goiter; and irregular or scant menses.
After teaching a client who is prescribed methimazole, the nurse determines that the teaching was effective when the client states which of the following? Select all that apply.
- A. I need to take the drug around the clock.
- B. I should call my primary health care provider if I have a fever.
- C. I can use any over-the-counter medications if I need to.
- D. I might have some tenderness and swelling of my neck.
- E. I don't need to monitor my weight like I did before.
Correct Answer: A,B
Rationale: The client taking methimazole should take the drug as prescribed around the clock and call the primary health care provider if he develops fever, sore throat, cough, easy bleeding or bruising, headache, or a general feeling of malaise. The client also needs to check with the prescriber before using any nonprescription drugs and monitor his weight twice a week, notifying the primary health care provider if there is any sudden weight gain or loss. Tenderness and swelling would be noted if the client received radioactive iodine for a procedure.
A nurse is caring for a client with thyrotoxicosis. The physician prescribes liotrix for the client. The nurse would be alert for the development of which of the following?
- A. Tachycardia
- B. Agranulogytosis
- C. Loss of hair
- D. Skin rash
Correct Answer: A
Rationale: The nurse should monitor for tachycardia, palpitations, headache, nervousness, insomnia, diarrhea, vomiting, weight loss, fatigue, sweating, and flushing as adverse reactions after administering liotrix to a client with thyrotoxicosis. Agranulocytosis, loss of hair, and skin rash are not the adverse reactions to liotrix; they are adverse reactions found in a client receiving a methimazole drug.