Nokea
A physician has prescribed desiccated thyroid USP for thyroid-stimulating hormone suppression. The client is also taking serotonin reuptake inhibitors to overcome depression. The nurse would be alert to the development of which of the following due to the interaction of the two drugs?
- A. Prolonged bleeding
- B. Decreased effectiveness of the thyroid drug
- C. Increased risk of paresthesias
- D. Increased risk of hypoglycemia
Correct Answer: B
Rationale: The nurse should monitor for a decreased effectiveness of the thyroid drug as the result of the interaction between desiccated thyroid USP and serotonin reuptake inhibitors. When the client is receiving desiccated thyroid USP with serotonin reuptake inhibitors, there is no increase in the risk of paresthesias, hypoglycemia, or prolonged bleeding. When the client is receiving oral anticoagulants with thyroid hormones, the client is at risk of prolonged bleeding. Increased risk of hypoglycemia occurs when oral hypoglycemics and insulin are administered with thyroid hormones to the client. The nurse should observe for paresthesias as one of the adverse reactions in a client receiving antithyroid drugs.
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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 nurse educating a client and his family about levothyroxine for the treatment of hypothyroidism should include which of the following information? Select all that apply.
- A. Therapy is lifelong.
- B. Drug is taken in the evening.
- C. Therapy needs to be evaluated every week initially.
- D. Weekly weights are needed with significant changes reported.
- E. Changing brands of the drug is okay.
Correct Answer: A,D
Rationale: A nurse educating a client and his family about levothyroxine includes the following: therapy is lifelong, dose is taken in the morning before breakfast, therapy needs to be evaluated every 2 weeks initially, weekly weights are needed and significant changes are reported to the physician, and the client should not change brands of the drug without consulting the physician.
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}.
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.
A nurse is caring for a client with hyperthyroidism. The physician prescribes methimazole to the client. The nurse observes that the client has developed skin rashes after the drug is administered. Which of the following interventions should the nurse perform while caring for the client?
- A. Offer suggestions to alter the drug schedule.
- B. Instruct the client to avoid applying lubricants.
- C. Instruct the client to use soap sparingly.
- D. Check if discoloration of the hair occurs.
Correct Answer: C
Rationale: The nurse should instruct the client to use soap sparingly and apply soothing creams or lubricants until the rash subsides. The nurse need not offer suggestions to alter the drug schedule, instruct the client to avoid applying lubricants, or check if discoloration of hair occurs.