Nokea
A nurse is caring for a client who is prescribed thyroid hormone replacement. From which of the following signs during ongoing assessment should the nurse conclude that the client is responding to the therapy?
- A. Increased appetite
- B. Swollen neck
- C. Excessive sweating
- D. Flushing
Correct Answer: A
Rationale: The nurse should observe for signs of therapeutic responses, which include increased appetite, weight loss, mild diuresis, an increased pulse rate, and decreased puffiness of the face, hands, and feet. The nurse need not observe for swollen neck, excessive sweating, or heat intolerance as signs of responding to therapy. Swollen neck, sore throat, and cough may occur after 2 to 3 days of administering radioactive iodine. Sweating and flushing are the adverse reactions to thyroid hormones.
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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.
When describing the thyroid gland, the nursing instructor would include which hormones as being secreted by the thyroid gland? Select all that apply.
- A. Thyroid-stimulating hormone
- B. Adrenocorticotropic hormone
- C. Thyroxine
- D. Prolactin
- E. Tri-iodothyronine
Correct Answer: C,E
Rationale: Thyroxine and tri-iodothyronine are hormones secreted by the thyroid gland. The anterior pituitary secretes thyroid-stimulating hormone. Prolactin and adrenocorticotropic hormone are secreted by the pituitary gland.
A client with a heart condition controlled on which of the following drugs must be monitored closely by the nurse for worsening atrial fibrillation if levothyroxine is initiated to treat hypothyroidism? Select all that apply.
- A. Lisinopril (Prinivil)
- B. Digoxin (Lanoxin)
- C. Diltiazem (Cardizem)
- D. Metoprolol (Toprol)
- E. Warfarin (Coumadin)
Correct Answer: B,D
Rationale: A client with a heart condition controlled on digoxin (Lanoxin) and metoprolol (Toprol) must be monitored closely by the nurse for worsening atrial fibrillation if levothyroxine is initiated to treat hypothyroidism because levothyroxine can decrease the effectiveness of digoxin and beta blockers (metoprolol).
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.
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.