Nokea
The nurse is planning teaching for a patient who was admitted with myxedema coma and diagnosed with hypothyroidism. Which of the following strategies is best for the nurse to use?
- A. Delay teaching until patient discharge.
- B. Ensure privacy by asking visitors to leave.
- C. Provide written handouts of all information.
- D. Offer multiple options for management of therapies.
Correct Answer: C
Rationale: Written instructions will be helpful to the patient because initially the hypothyroid patient may be unable to remember to take medications and other aspects of self-care. Since the treatment regimen is somewhat complex, teaching should be initiated well before discharge. Family members or friends should be included in teaching because the hypothyroid patient is likely to forget some aspects of the treatment plan. A simpler regimen will be easier to understand until the patient is euthyroid.
You may also like to solve these questions
Which of the following actions should the nurse take first when caring for a patient who has just arrived on the unit after a thyroidectomy?
- A. Check the dressing for bleeding.
- B. Assess respiratory rate and effort.
- C. Take the blood pressure and pulse.
- D. Support the patient's head with pillows.
Correct Answer: B
Rationale: Airway obstruction is a possible complication after thyroidectomy because of swelling or bleeding at the site or tetany, and the priority nursing action is to assess the airway. The other actions are also part of the standard nursing care post-thyroidectomy but are not as high in priority.
The nurse is teaching a patient with persistent syndrome of inappropriate antidiuretic hormone (SIADH) about long-term management. Which of the following patient statements indicate that additional instruction is needed?
- A. I should weigh myself daily and report any sudden weight loss or gain.
- B. I need to limit my fluid intake to no more than 1 L of liquids a day.
- C. I will eat foods high in potassium because the diuretics cause potassium loss.
- D. I need to shop for foods that are low in sodium and avoid adding salt to foods.
Correct Answer: D
Rationale: Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred.
The nurse is caring for a patient with Cushing's syndrome who returns to the surgical unit following an adrenalectomy. Which of the following actions during the initial postoperative period has the highest priority?
- A. Monitoring for infection
- B. Protecting the patient's skin
- C. Maintaining fluid and electrolyte status
- D. Preventing severe emotional disturbances
Correct Answer: C
Rationale: After adrenalectomy, the patient is at risk for circulatory instability caused by fluctuating hormone levels, and the focus of care is to assess and maintain fluid and electrolyte status through the use of IV fluids and corticosteroids. The other goals are also important for the patient but are not as immediately life-threatening as the circulatory collapse that can occur with fluid and electrolyte disturbances.
The nurse is caring for a patient with acute adrenal insufficiency. Which of the following findings indicate that the prescribed therapies are effective?
- A. Increasing serum sodium levels
- B. Decreasing blood glucose levels
- C. Decreasing serum chloride levels
- D. Increasing serum potassium levels
Correct Answer: A
Rationale: Clinical manifestations of Addison's disease include hyponatremia and an increase in sodium level indicates improvement. The other values indicate that treatment has not been effective.
The nurse is caring for a patient following a parathyroidectomy who develops tingling of the lips and a positive Trousseau's sign. Which of the following actions should the nurse take first?
- A. Administer the ordered muscle relaxant.
- B. Give the ordered oral calcium supplement.
- C. Start the PRN oxygen at 2 L minute per cannula.
- D. Have the patient rebreathe using a paper bag.
Correct Answer: D
Rationale: The patient's symptoms suggest mild hypocalcemia. The symptoms of hypocalcemia will be temporarily reduced by having the patient breathe into a paper bag, which will raise the PaCO2 and create a more acidic pH. The muscle relaxant will have no impact on the ionized calcium level. Although severe hypocalcemia can cause laryngeal stridor, there is no indication that this patient is experiencing laryngeal stridor or needs oxygen. Calcium supplements will be given to normalize calcium levels quickly, but oral supplements will take time to be absorbed.