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.
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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 describing the action of thyroid hormones to a client. The nurse would include information that thyroid hormones are principally concerned with the increase in the metabolic rate of tissues that can result in which of the following? Select all that apply.
- A. Increased heart rate
- B. Decreased respiratory rate
- C. Increased body temperature
- D. Increased cardiac output
- E. Decreased oxygen consumption
Correct Answer: A,C,D
Rationale: Thyroid hormones are principally concerned with the increase in the metabolic rate of tissues, which results in increases in the heart and respiratory rate, body temperature, cardiac output, oxygen consumption, and metabolism of fats, proteins, and carbohydrates.
After teaching a client who is prescribed methimazole, the nurse determines that the teaching was effective when the client states which of the following? Select all that apply.
- A. I need to take the drug around the clock.
- B. I should call my primary health care provider if I have a fever.
- C. I can use any over-the-counter medications if I need to.
- D. I might have some tenderness and swelling of my neck.
- E. I don't need to monitor my weight like I did before.
Correct Answer: A,B
Rationale: The client taking methimazole should take the drug as prescribed around the clock and call the primary health care provider if he develops fever, sore throat, cough, easy bleeding or bruising, headache, or a general feeling of malaise. The client also needs to check with the prescriber before using any nonprescription drugs and monitor his weight twice a week, notifying the primary health care provider if there is any sudden weight gain or loss. Tenderness and swelling would be noted if the client received radioactive iodine for a procedure.
After teaching a group of nursing students about thyroid drugs, the instructor determines that the teaching was successful when the students identify which of the following as an antithyroid drug? Select all that apply.
- A. Propylthiouracil
- B. Levothyroxine
- C. Liotrix
- D. Desiccated thyroid
- E. Methimazole
Correct Answer: A,E
Rationale: Propylthiouracil and methimazole are antithyroid drugs. Levothyroxine, liotrix, and desiccated thyroid are thyroid hormone supplements.
During ongoing assessment the nurse should observe a client taking levothyroxine for which of the following indicating a therapeutic response? Select all that apply.
- A. Weight loss
- B. Mild diuresis
- C. Increased appetite
- D. Increased mental activity
- E. Decreased pulse rate
Correct Answer: A,B,C,D
Rationale: Signs of therapeutic response to levothyroxine include weight loss; mild diuresis; increased appetite; increased pulse rate; decreased puffiness of face, hands, and feet; and client report of increased mental activity and increased sense of well-being.
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