Nokea
The nurse should observe the patient for which major life-threatening complication postoperatively of a thyroidectomy?
- A. Hemorrhaging
- B. Seizures
- C. Tetany
- D. Hypoglycemia
- E. Thyroid crisis (storm)
- F. SIADH
Correct Answer: A,C,E
Rationale: The nurse must be alert for signs of internal or external bleeding. In addition to hemorrhage, two significant postoperative complications exist after thyroidectomy. The first is tetany. The second is thyroid crisis. Manipulation of the thyroid during surgery may cause the release of large amounts of thyroid hormones into the bloodstream, creating a thyroid crisis (storm).
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The nurse explains that the negative feedback inhibition controls hormone release by communication between which two anatomical areas?
- A. the pituitary and the target organ.
- B. the thymus and the bloodstream.
- C. lymphatic system and the target organ.
- D. central nervous system and the bloodstream.
Correct Answer: A
Rationale: The amount of hormone released is controlled by negative feedback inhibition. The negative feedback inhibition process is when a gland releases a primary hormone, which stimulates target cells to release a secondary hormone; the gland slows the release of the primary hormone as it senses the rise of the secondary hormone. Information is constantly being exchanged via the bloodstream between target organs and endocrine glands.
Only ___ insulin can be administered intravenously.
Correct Answer: regular
Rationale: Insulin is given subcutaneously, although intravenous (IV) administration of regular insulin can be done when immediate onset of action is desired.
The health care provider orders an 1800-calorie diabetic diet and 40 units of NPH insulin subcutaneously daily for a patient with diabetes mellitus. For which reason will a mid-afternoon snack of milk and crackers be given?
- A. To improve nutrition.
- B. To improve carbohydrate metabolism.
- C. To prevent hypoglycemia
- D. To prevent diabetic coma.
Correct Answer: C
Rationale: NPH insulin peaks in 6-10 hours. The nurse should be alert for signs of hypoglycemia (low blood glucose) at the peak of action of whatever type of insulin the patient is receiving.
To which diet should a patient with Cushing syndrome adhere?
- A. Less sodium
- B. More calories
- C. Less potassium
- D. More carbohydrates
Correct Answer: A
Rationale: The diet should be lower in sodium to help decrease edema.
Which extra equipment will the nurse provide at the bedside of a patient who has returned to the nursing unit after a thyroidectomy three hours ago?
- A. Large bandage scissors
- B. Tracheotomy tray
- C. Ventilator
- D. Water-sealed drainage system
Correct Answer: B
Rationale: There should be a suction apparatus and tracheotomy tray available for emergency use.