Nokea
A client is diagnosed with hypothyroidism. Which of the following would the nurse expect to assess? Select all that apply.
- A. Elevated body temperature
- B. Weight gain
- C. Bradycardia
- D. Hypertension
- E. Sleepiness
Correct Answer: B,C,E
Rationale: The signs and symptoms of hypothyroidism include decreased metabolism; cold intolerance; low body temperature; weight gain; bradycardia; hypotension; lethargy; sleepiness; pale, cool, dry skin; face appearing puffy; coarse hair; thick, hard nails; heavy menses; fertility problems; and low sperm count.
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A nurse educating a client and his family about levothyroxine for the treatment of hypothyroidism should include which of the following information? Select all that apply.
- A. Therapy is lifelong.
- B. Drug is taken in the evening.
- C. Therapy needs to be evaluated every week initially.
- D. Weekly weights are needed with significant changes reported.
- E. Changing brands of the drug is okay.
Correct Answer: A,D
Rationale: A nurse educating a client and his family about levothyroxine includes the following: therapy is lifelong, dose is taken in the morning before breakfast, therapy needs to be evaluated every 2 weeks initially, weekly weights are needed and significant changes are reported to the physician, and the client should not change brands of the drug without consulting the physician.
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 client presents to the physician's office with complaints of worsening hypothyroidism symptoms. When questioned about medication changes, the client tells the nurse that she has recently started taking an antidepressant prescribed by another physician. Which of the following antidepressants can decrease the effectiveness of levothyroxine?
- A. Amitriptyline (Elavil)
- B. Quetiapine (Seroquel)
- C. Sertraline (Zoloft)
- D. Fluoxetine (Prozac)
- E. Topiramate (Topamax)
Correct Answer: C,D
Rationale: Selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft) and fluoxetine (Prozac), can decrease the effectiveness of levothyroxine, leading to the reappearance of hypothyroidism symptoms in clients previously controlled on a dose of levothyroxine.
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.
After teaching a group of nursing students about thyroid drugs, the instructor determines that the teaching was successful when the students identify which of the following as an antithyroid drug? Select all that apply.
- A. Propylthiouracil
- B. Levothyroxine
- C. Liotrix
- D. Desiccated thyroid
- E. Methimazole
Correct Answer: A,E
Rationale: Propylthiouracil and methimazole are antithyroid drugs. Levothyroxine, liotrix, and desiccated thyroid are thyroid hormone supplements.