Nokea
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.
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A client is diagnosed with hypothyroidism. Which of the following would the nurse expect to assess? Select all that apply.
- A. Elevated body temperature
- B. Weight gain
- C. Bradycardia
- D. Hypertension
- E. Sleepiness
Correct Answer: B,C,E
Rationale: The signs and symptoms of hypothyroidism include decreased metabolism; cold intolerance; low body temperature; weight gain; bradycardia; hypotension; lethargy; sleepiness; pale, cool, dry skin; face appearing puffy; coarse hair; thick, hard nails; heavy menses; fertility problems; and low sperm count.
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.
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.
A group of nursing students are reviewing information about thyroid disorders. The students demonstrate understanding of the information when they identify which of the following as indicative of hyperthyroidism? Select all that apply.
- A. Low body temperature
- B. Weight loss
- C. Tachycardia
- D. Hypotension
- E. Sleepiness
Correct Answer: B,C
Rationale: The signs and symptoms of hyperthyroidism 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.
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).