Nokea
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.
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A nurse caring for a client who is receiving warfarin (Coumadin) will monitor for signs of bleeding if which of the following thyroid hormone-regulating drugs is initiated? Select all that apply.
- A. Propylthiouracil (PTU)
- B. Desiccated thyroid (Armour Thyroid)
- C. Liotrix (Thyrolar)
- D. Methimazole (Tapazole)
- E. Liothyronine (Triostat)
Correct Answer: A,B,C,D,E
Rationale: All of the thyroid hormone replacement drugs and methimazole (Tapazole) and propylthiouracil (PTU) can increase the risk for bleeding, especially in clients taking warfarin (Coumadin).
A client diagnosed with hyperthyroidism has been prescribed propylthiouracil. After administering the drug, the nurse would assess the client for which of the following?
- A. Skin rash
- B. Tachycardia
- C. Nervousness
- D. Constipation
Correct Answer: A
Rationale: The adverse reactions to propylthiouracil include paresthesias, numbness, headache, skin rash, nausea, vomiting, and agranulocytosis. The nurse need not observe for tachycardia, nervousness, and constipation as adverse reactions associated with propylthiouracil. Tachycardia, nervousness, and vomiting are the adverse reactions associated with the thyroid hormone levothyroxine sodium \left(\mathrm{T}_4\right).
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 preparing to administer the thyroid hormone replacement drug levothyroxine to a client. The nurse understands which of the following about this drug? Select all that apply.
- A. Equivalent to all other thyroid hormone replacement drugs
- B. More uniform potency than other thyroid hormone replacement drugs
- C. Twice-daily dosing necessary
- D. Relatively inexpensive
- E. Less frequent lab monitoring required
Correct Answer: B,D
Rationale: The following is true of the thyroid hormone replacement drug levothyroxine: it is relatively inexpensive, requires once-daily dosing, and has a more uniform potency than do other thyroid hormone replacement drugs.
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.