Nokea
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.
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A nurse is caring for a client with hyperthyroidism. The physician prescribes methimazole to the client. The nurse observes that the client has developed skin rashes after the drug is administered. Which of the following interventions should the nurse perform while caring for the client?
- A. Offer suggestions to alter the drug schedule.
- B. Instruct the client to avoid applying lubricants.
- C. Instruct the client to use soap sparingly.
- D. Check if discoloration of the hair occurs.
Correct Answer: C
Rationale: The nurse should instruct the client to use soap sparingly and apply soothing creams or lubricants until the rash subsides. The nurse need not offer suggestions to alter the drug schedule, instruct the client to avoid applying lubricants, or check if discoloration of hair occurs.
A nurse is describing the action of thyroid hormones to a client. The nurse would include information that thyroid hormones are principally concerned with the increase in the metabolic rate of tissues that can result in which of the following? Select all that apply.
- A. Increased heart rate
- B. Decreased respiratory rate
- C. Increased body temperature
- D. Increased cardiac output
- E. Decreased oxygen consumption
Correct Answer: A,C,D
Rationale: Thyroid hormones are principally concerned with the increase in the metabolic rate of tissues, which results in increases in the heart and respiratory rate, body temperature, cardiac output, oxygen consumption, and metabolism of fats, proteins, and carbohydrates.
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 physician has prescribed a thyroid supplement for a client with euthyroid goiter. Which of the following should the nurse include in the nursing diagnosis checklist?
- A. Disturbed Thought Processes related to adverse drug reactions
- B. Anxiety related to symptoms, adverse reactions, and treatment regimen
- C. Risk for Infection related to adverse drug reactions
- D. Risk for Impaired Skin Integrity related to adverse reactions
Correct Answer: B
Rationale: The nurse should include Anxiety related to symptoms, adverse reactions, and treatment regimen as a nursing diagnosis. Disturbed Thought Processes related to adverse drug reactions, Risk for Infection, and Risk for Impaired Skin Integrity related to adverse drug reactions are inappropriate Risk for Infection related to adverse drug reactions and Risk for Impaired Skin Integrity related to adverse reactions would be appropriate for a client receiving antithyroid drugs. Disturbed Thought Processes may apply for a client receiving \mathrm{ACTH}.
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.