Prep U Ch 52

Margaret Lawson, a 52-year-old grocery clerk, has been experiencing a decrease in serum calcium. She has undergone diagnostics, and her physician proposes her calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands?

4

Which hormone would be responsible for increasing blood glucose levels by stimulating glycogenolysis?

Glucagon -Glucagon is a hormone released by the alpha islet cells of the pancreas that raises blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen into glucose in the liver).

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?

Levothyroxine sodium -Hypothyroidism is treated with thyroid replacement therapy, in the form of dessicated thyroid extract or a synthetic product, such as levothyroxine sodium (Synthroid) or liothyronine sodium (Cytomel). Methimazole and propylthiouracil are antithyroid agents used to treat hyperthyroidism. Propranolol is a beta blocker that can be used to treat hyperthyroidism.

A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do?

Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes. -Muscle twitching and numbness or tingling of the lips, fingers, and toes are signs of hyperirritability of the nervous system due to hypocalcemia. The other options describe complications for which the nurse should also be observing; however, tetany and neurologic alterations are primary indications of hypocalcemia.

A nurse explains to a client with thyroid disease that the thyroid gland normally produces:

T3, thyroxine (T4), and calcitonin. -The thyroid gland normally produces thyroid hormone (T3 and T4) and calcitonin. The pituitary gland produces TSH to regulate the thyroid gland. The hypothalamus gland produces TRH to regulate the pituitary gland.

Wendy Corcoran, a 34-year-old teacher, is being seen at the primary care group where you practice nursing. She is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by her altered thyroid function?

metabolic rate -The thyroid concentrates iodine from food and uses it to synthesize thyroxine (T4) and triiodothyronine (T3). These two hormones regulate the body's metabolic rate. Metabolic rate would be altered.

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit?

moon face -Clients who are receiving long-term high-dose corticosteroid therapy often develop a cushingoid appearance, manifested by facial fullness and the characteristic moon face. They also may exhibit weight gain, peripheral edema, and hypertension due to sodium and water retention. The skin is usually thin, and ruddy.

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?

myxedema coma -Myxedema coma is a rare life-threatening condition. It is the decompensated state of severe hypothyroidism in which the patient is hypothermic and unconscious (Ross, 2012a). This condition may develop with undiagnosed hypothyroidism and may be precipitated by infection or other systemic disease or by use of sedatives or opioid analgesic agents. Patients may also experience myxedema coma if they forget to take their thyroid replacement medication.

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism?

myxedemic coma -Severe hypothyroidism is called myxedema and if untreated, it can progress to myxedemic coma, a life-threatening event. Thyroid storm is an acute, life-threatening form of hyperthyroidism.

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:

phosphorus.