Nokea
A physician has prescribed a thyroid supplement for a client with euthyroid goiter. Which of the following should the nurse include in the nursing diagnosis checklist?
- A. Disturbed Thought Processes related to adverse drug reactions
- B. Anxiety related to symptoms, adverse reactions, and treatment regimen
- C. Risk for Infection related to adverse drug reactions
- D. Risk for Impaired Skin Integrity related to adverse reactions
Correct Answer: B
Rationale: The nurse should include Anxiety related to symptoms, adverse reactions, and treatment regimen as a nursing diagnosis. Disturbed Thought Processes related to adverse drug reactions, Risk for Infection, and Risk for Impaired Skin Integrity related to adverse drug reactions are inappropriate Risk for Infection related to adverse drug reactions and Risk for Impaired Skin Integrity related to adverse reactions would be appropriate for a client receiving antithyroid drugs. Disturbed Thought Processes may apply for a client receiving \mathrm{ACTH}.
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A client is diagnosed with euthyroid goiter. The nurse would expect to administer which of the following?
- A. Levothyroxine
- B. Methimazole
- C. Propylthiouracil
- D. Sodium iodide
Correct Answer: A
Rationale: Euthyroid goiter is treated with thyroid hormones, such as levothyroxine. Methimazole, propylthiouracil, and sodium iodide are used to treat hyperthyroidism.
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 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 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 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).