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The nurse is caring for a patient with a diagnosis of Cushing's syndrome. Which of the following data should the nurse anticipate finding during the admission assessment?
- A. Persistently low blood pressure
- B. Bronzed appearance of the skin
- C. Decreased axillary and pubic hair
- D. Purplish red streaks on the abdomen
Correct Answer: D
Rationale: Purplish-red striae on the abdomen are a common clinical manifestation of Cushing's syndrome. Hypotension and bronzed-appearing skin are manifestations of Addison's disease. Decreased axillary and pubic hair occur with androgen deficiency.
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The nurse is caring for a patient with Graves' disease who has to,2026. 11:3.29. following actionspl. All is included in the plan of care?
- A. Apply eye patches to protect the cornea from irritation.
- B. Place cold packs on the eyes to
- C. Elevate the head of the patient's bed to reduce periorbital
- D. Teach the patient to blink every few seconds to lubric
Correct Answer: C
Rationale: The patient should sit upright as much as possible to promote fluid drainage from the periorbital area. With exophthalmos, the patient is unable to close the eyes completely. Lubrication of the eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swelling of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful.
A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. Which of the following actions should the nurse anticipate implementing first?
- A. Infuse IV calcium gluconate.
- B. Suction the patient's airway.
- C. Prepare for endotracheal intubation.
- D. Assist with emergency tracheotomy
Correct Answer: A
Rationale: The patient's clinical manifestations of stridor and cramping are consistent with tetany caused by hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubation or tracheotomy may be needed if the calcium does not resolve the stridor. Suctioning will not correct the stridor.
Which of the following information should the nurse include when teaching a patient who has been newly diagnosed with Graves' disease?
- A. Exercise is contraindicated to avoid increasing metabolic rate.
- B. Restriction of iodine intake is needed to reduce thyroid activity.
- C. Surgery will eventually be required to remove the thyroid gland.
- D. Antithyroid medications may take several weeks to have an effect.
Correct Answer: D
Rationale: Medications used to block the synthesis of thyroid hormones may take several weeks before an effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves' disease although surgery may be used.
Which of the following findings for a patient who takes levothyroxine to treat hypothyroidism indicates that the nurse should contact the health care provider before administering the medication?
- A. Increased thyroxine (T4) level
- B. Blood pressure 102/62 mm Hg
- C. Distant and difficult to hear heart sounds
- D. Elevated thyroid stimulating hormone level
Correct Answer: A
Rationale: An increased thyroxine level indicates the levothyroxine dose needs to be decreased. The other data are consistent with hypothyroidism and the nurse should administer the Synthroid.
The nurse is caring for a patient with hyperthyroidism who is being treated with radioactive iodine (RAI) at the clinic. Which of the following information should the nurse provide to the patient prior to discharge?
- A. Symptoms of hyperthyroidism should be relieved in about a week.
- B. Hypothyroidism may occur as the RAI therapy takes effect.
- C. Discontinue the antithyroid medications taken before the radioactive therapy.
- D. Teach radioactive precautions to use with urine, stool, and other body secretions.
Correct Answer: B
Rationale: There is a high incidence of postradiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism. RAI has a delayed response, with the maximum effect not seen for 2-3 months, and the patient will continue to take antithyroid medications during this time. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed.