Chapter 63: Care for Patients with Problems of the Thyroid and Parathyroid Glands

A nurse assesses a client with hypothyroidism who is admitted with acute appendicitis. The nurse notes that the clients level of consciousness has decreased. Which actions should the nurse take? (Select all that apply) a. Infuse intravenous fluids. b. Cover the client with warm blanket c. Monitor blood pressure every 4 hours d. Maintain patent airway e. Administer oral glucose as prescribed

A,B,D A. Infuse intravenous fluids. B. Cover the client with warm blanket D. Maintain patent airway

A nurse teaches a client with hyperthyroidism. Which dietary modifications should the nurse include in this clients teaching? (Select all that apply) a. Increased carbohydrates b. Decreased fats c. Increased calorie intake d. Supplemental vitamins e. Increased proteins

A,C,E A. Increased carbohydrates C. Increased calorie intake E. Increased proteins

A nurse teaches a client who is prescribed an unsealed radioactive isotope. Which statement should the nurse include in this clients education? (Select all that apply) a. Do not share utensils, plates, and cups with anyone else. b. You can play with your grandchild for 1 hour each day. c. eat foods high in vitamins such as apples, pears, and oranges. d. Wash your clothing separate from others in the household. e. Take a laxative 2 days after therapy to excrete the radiation.

A,D,E A. Do not share utensils, plates, and cups with anyone else. D. Wash your clothing separate from others in the household. E. Take a laxative 2 days after therapy to excrete the radiation.

While assessing a client with Grave's disease, the nurse notes that the client's temperature has risen 1 F. Which action should the nurse take first? a. Turn the lights down and shut the clients door. b. Call for an immediate electrocardiogram (ECG) c. Calculate the clients apical-radial pulse deficit d. Administer a dose of acetaminophen (Tylenol)

A. Turn the lights down and shut the clients door.

A nurse evaluates the following laboratory results for a client who has hypoparathyroidism: Calcium 7.2 mg/dL Sodium 144 mEq/L Magnesium 1.2 mEq/L Potassium 5.7 mEq/L Based on these results, which medications should the nurse anticipate administering? (Select all that apply) a. Oral potassium chloride b. Intravenous calcium chloride c. 3% normal saline IV solution d. 50% Magnesium sulfate e. Oral calcitriol (Rocaltrol)

B,D B. Intravenous calcium chloride D. d. 50% Magnesium sulfate

A nurse assesses a client for potential endocrine disorders. Which client is at greatest risk for hyperparathyroidism? a. A 29-year-old female with pregnancy-induced hypertension b. A 41-year-old male receiving dialysis for end-stage kidney disease c. A 66-year-old female with moderate heart failure d. A 72-year-old male who is prescribed home oxygen therapy

B. A 41-year-old male receiving dialysis for end-stage kidney disease

After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional instruction? a. I may need calcium replacement after surgery. b. After surgery, I wont need to take thyroid medication. c. I'll need to take thyroid hormones for the rest of my life. d. I can receive pain medication if I feel that I need it.

B. After surgery, I wont need to take thyroid medication.

A nurse cares for a client newly diagnosed with Graves Disease. The client's mother asks, " I have diabetes mellitus. Am I responsible for my daughter's disease?" How should the nurse respond? a. The fact that Graves diabetes did not cause your daughter to have Grave's disease. no connection is known between between Grave's disease and diabetes. b. An association has been noted between Grave's disease and Diabetes, but the fact that you have diabetes did not cause your daughter to have Grave' disease. c. Grave's disease is associated with autoimmune diseases such as rheumatoid arthritis, but not with a disease such as diabetes mellitus. d. Unfortunately, Graves disease is associated with diabetes, and your diabetes could have led to your daughters having Grave's disease.

B. An association has been noted between Grave's disease and Diabetes, but the fact that you have diabetes did not cause your daughter to have Grave' disease.

A nurse assesses a client with hyperthyroidism who is prescribed lithium carbonate. Which assessment finding alert the nurse to a side effect of this therapy? a. Blurred and double vision b. Increased thirst and urination c. Profuse nausea and diarrhea d. Decreased attention and insomnia

B. Increased thirst and urination

A nurse cares for a client who presents with bradycardia secondary to hypothyroidism. Which medication should the nurse anticipate being prescribed to the client? a. Atropine sulfate b. Levothyroxine (Synthroid) c. Propranolol (Inderal) d. Epinephrine (Adrenalin)

B. Levothyroxine (Synthroid)

A nurse plans care for a client with hyperparathyroidism. Which intervention should the nurse include in this clients plan of care? a. Ask the client to ambulate in the hallway twice a day. b. Use a lift sheet to assist with position changes. c. Provide the client with a soft-bristled toothbrush for oral care. d. Instruct the unlicensed assistive personnel to strain the clients urine for stones.

B. Use a lift sheet to assist with position changes.

A nurse cares for a client with elevated triiodothyronine anf thyroxine, and normal thyroid-stimulating hormone levels. Which actions should the nurse take? (Select all that apply) a. Administer levothyroxine (Synthroid) b. Administer propranolol (Inderal) c. Monitor apical pulse d. Assess for Trousseaus sign e. Initiate telemetry monitoring

C,E C. Monitor apical pulse E. Initiate telemetry monitoring

A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the second postoperative day the client states, " I feel numbness and tingling around my mouth." What action should the nurse take? a. Offer mouth care b. Loosen the dressing c. Assess for Chvostek's sign d. Ask the client orientation questions

C. Assess for Chvostek's sign

A nurse plans care for a client with hypothyroidism. Which priority problem should the nurse plan to address first for this client? a. Heat intolerance b. Body Image problems c. Depression and withdrawal d. Obesity and retention

C. Depression and withdrawal

A nurse plans care for a client who has hypothyroidism and is admitted for pneumonia. Which priority intervention should the nurse include in this clients plan of care? a. Monitor the clients intravenous site every shift b. Administer acetaminophen (Tylenol) for fever c. Ensure that working suction equipment is in the room. d. Assess the clients vital signs every 4 hours

C. Ensure that working suction equipment is in the room.

A nurse cares for a client who has hypothyroidism, as a result of Hashimotos thyroiditis. The client asks, " How long will I need to take this thyroid medication? How should the nurse respond? a. You will need to take the thyroid medication until the goiter is completely gone. b. Thyroiditis is cured with antibiotics. Then you wont need thyroid medication. c. You'll need thyroid pills for life because your thyroid wont start working again. d. When blood tests indicate normal thyroid function, you can stop the medication.

C. You'll need thyroid pills for life because your thyroid wont start working again.

A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor. Which action should the nurse take first? a. Reassure the client that the voice change is temporary b. Document the findings and assess the client hourly. c. Place the client in high-Fowler's position and apply oxygen d. Contact the provider and prepare for intubation

D. Contact the provider and prepare for intubation

A nurse assesses a client who is prescribed levothyroxine (Synthroid) for hypothyroidism. Which assessment finding should alert the nurse that the medication therapy is effective? a. Thirst is recognized and fluid is appropriate b. Weight has been the same for 3 weeks c. Total white blood cell count is 6000 cells/mm3 d. Heart rate is 70 beats/minute and regular

D. Heart rate is 70 beats/minute and regular

A nurse assesses a client on the medical-surgical unit. Which statement made by the client should alert the nurse to the possibility of hypothyroidism? a. My sister has thyroid problems. b. I seen to feel the heat more than other people. c. Food just doesn't taste good without a lot a salt. d. I am always tired, even with 12 hours of sleep.

D. I am always tired, even with 12 hours of sleep.

A nurse cares for a client who is recovering from a parathyroidectomy. When taking the clients blood pressure, the nurse notes that the clients hand has gone into flexion contractions. Which laboratory results does the nurse correlate with this condition? a. Serum Potassium 2.9 mEq/L b. Serum magnesium: 1.7 mEq/L c. Serum sodium: 122 mEq/L d. Serum calcium: 6.9mg/dL

D. Serum calcium: 6.9mg/dL