Nokea
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.
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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.
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 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 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 caring for a client with chronic lymphocytic thyroiditis. The physician has prescribed liothyronine to the client. The nurse understands that the drug is administered cautiously to clients with which of the following?
- A. Upper respiratory tract infection
- B. Diabetes
- C. Elevated body temperature
- D. Cardiac disease
Correct Answer: D
Rationale: The nurse should be cautious about existing conditions such as cardiac disease and also cautious about factating clients before administering liothyronine to clients with chronic lymphocytic thyroiditis. The nurse need not be cautious about administering liothyronine to clients with an upper respiratory tract infection, diabetes, or elevated body temperature. The nurse should be cautious about clients contracting an upper respiratory tract infection on administrating antithyroid drugs. A client with diabetes may experience an increase in diabetes while undergoing thyroid hormone replacement therapy. The nurse should observe for elevated body temperature while managing the needs of a client administered thyroid hormones.