Nokea
A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of which potentially lethal complication?
- A. severe nausea and vomiting.
- B. bradycardia.
- C. delirium with restlessness.
- D. congestive heart failure.
Correct Answer: D
Rationale: In thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. The patient may develop congestive heart failure and die.
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The nurse should observe the patient for which major life-threatening complication postoperatively of a thyroidectomy?
- A. Hemorrhaging
- B. Seizures
- C. Tetany
- D. Hypoglycemia
- E. Thyroid crisis (storm)
- F. SIADH
Correct Answer: A,C,E
Rationale: The nurse must be alert for signs of internal or external bleeding. In addition to hemorrhage, two significant postoperative complications exist after thyroidectomy. The first is tetany. The second is thyroid crisis. Manipulation of the thyroid during surgery may cause the release of large amounts of thyroid hormones into the bloodstream, creating a thyroid crisis (storm).
The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury expects to see which aspect emphasized in the plan of care?
- A. limiting fluids to 1500 mL a day.
- B. encouraging physical exercise.
- C. protecting patient from injury.
- D. discouraging daytime naps.
Correct Answer: C
Rationale: The patients need protection from injury because they are often exhausted from sleep deprivation and having to get up frequently at night. Fluids should not be limited and their energy should be preserved.
Which extra equipment will the nurse provide at the bedside of a patient who has returned to the nursing unit after a thyroidectomy three hours ago?
- A. Large bandage scissors
- B. Tracheotomy tray
- C. Ventilator
- D. Water-sealed drainage system
Correct Answer: B
Rationale: There should be a suction apparatus and tracheotomy tray available for emergency use.
Which instructions will the nurse reinforce in the discharge instructions for a 47-year-old patient with hypothyroidism?
- A. Taking medication whenever symptoms cause discomfort
- B. Decreasing fluid and fiber intake
- C. Consuming foods rich in iron
- D. Seeing the health care provider regularly for follow-up care
Correct Answer: D
Rationale: Regular checkups are essential, because drug dosage may have to be adjusted from time to time.
A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with which endocrine gland?
- A. pituitary gland.
- B. adrenal glands.
- C. thyroid gland.
- D. pancreas.
Correct Answer: A
Rationale: The pituitary gland may produce an overabundance of growth hormone. This overproduction of hormones may cause changes throughout the patient's body, including enlargement of the pituitary gland and hands and feet. Female patients may develop a deepened voice, increased facial hair growth, and amenorrhea. In a fully grown adult, this condition is acromegaly.