Nokea
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.
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A nurse is providing care to a client with hyperthyroidism. Which treatment modalities would the nurse anticipate being used? Select all that apply.
- A. Levothyroxine (Synthroid)
- B. Methimazole (Tapazole)
- C. Radioactive iodine(I-131)
- D. Propylthiouracil (PTU)
- E. Subtotal thyroidectomy
Correct Answer: B,C,D,E
Rationale: Methimazole (Tapazole), propylthiouracil (PTU), radioactive iodine (I-131), and subtotal thyroidectomy are treatment modalities used in the treatment of clients with hyperthyroidism.
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.
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.
A physician has ordered an iodine procedure for a client with thyroid dysfunction. What should be included in the nurse's preadministration assessment for the client? Select all that apply.
- A. Allergy history
- B. Weight
- C. Pulse
- D. Blood glucose
- E. Temperature
Correct Answer: A,B,C,E
Rationale: The nurse's preadministration assessment for the client should include vital signs (blood pressure, respiratory rate, pulse, and temperature), allergy history, weight, and notation regarding the outward symptoms of the hyperthyroidism.
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.