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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.
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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.
When developing a plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH), which of the following interventions should the nurse include?
- A. Encourage fluids to 2000 mL/day.
- B. Offer patient ice chips to suck on.
- C. Monitor for increased peripheral edema.
- D. Keep head of bed elevated to 30 degrees.
Correct Answer: B
Rationale: Sucking on ice chips or chewing sugarless gum decreases thirst for a patient on fluid restriction. Patients with SIADH are on fluid restrictions of 800-1000 mL/day. Peripheral edema is not seen with SIADH. The head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and decrease antidiuretic hormone (ADH) release.
The nurse is providing preoperative teaching for a patient scheduled for a hypophysectomy for treatment of a pituitary adenoma. Which of the following instructions should the nurse include in patient teaching?
- A. Cough and deep breathe every 2 hours postoperatively
- B. Bed rest for the first 24 hours after the surgery
- C. Be positioned flat with sandbags at the head postoperatively
- D. Have a NG tube after the surgery
Correct Answer: D
Rationale: The patient should be taught that they will have a NG tube after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line. The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica and decrease the risk for headaches.
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.
Which of the following assessment findings for a patient admitted with Graves' disease requires the most rapid intervention by the nurse?
- A. BP 166/100 mm Hg
- B. Bilateral exophthalmos
- C. Heart rate 136 beats/minute
- D. Temperature 40.4°C (104.7°F)
Correct Answer: D
Rationale: The patient's temperature indicates that the patient may have thyrotoxic crisis and that interventions to lower the temperature are needed immediately. The other findings also require intervention but do not indicate potentially life-threatening complications.