ch 49 Endocrine
hallmark symptom of hypocalcemia
tetany (tingling of the lips and stiffness in extremities)
why are beta blockers used to treat hyperthyroidism?
they reduce symptoms such as palpitations and nervousness
Which of the following are symptoms associated with hyperthyroidism? a. tachycardia and palpitations b. constipation and weight gain c. cool, dry, pale skin d. somnolence and cold intolerance
a. tachycardia and palpitations (other symptoms = hypothyroidism)
T4 levels in hypothyroidism
decreased
increased appetite: hypothyroidism or hyperthyroidism?
hyperthyroidism
myxedema coma symptoms (8)
-respiratory failure -hypotension -hypothermia -bradycardia -dysrhythmias -coma -hypoglycemia -hyponatremia
A client is admitted to the hospital with a diagnosis of Addison's disease. The nurse would assess for which problem as a manifestation of this disorder? 1. Edema 2. Obesity 3. Hirsutism 4. Hypotension
4. Hypotension NCLEX
normal T4 levels
5-12 mcg/dL
adrenal insufficiency: Cushing syndrome or Addison's disease?
Addison's disease
confusion: Cushing syndrome or Addison's disease?
Addison's disease
hypernatremia: Cushing syndrome or Addison's disease?
Cushing syndrome
hypokalemia: Cushing syndrome or Addison's disease?
Cushing syndrome
inhibition of immune response/increased susceptibility to infection: Cushing syndrome or Addison's disease?
Cushing syndrome
blood glucose: Cushing's vs Addison's
-Cushing's: hyperglycemia -Addison's: hypoglycemia
thyroidectomy complications (3)
-hypocalcemia (damage to parathyroid gland) -respiratory obstruction (swelling) -hemorrhage
The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a client problem of excess fluid volume. Which nursing actions should be included in the care plan for this client? Select all that apply. 1. Monitor daily weight. 2. Monitor intake and output. 3. Assess extremities for edema. 4. Maintain a high-sodium diet. 5. Maintain a low-potassium diet.
1. Monitor daily weight. 2. Monitor intake and output. 3. Assess extremities for edema. NCLEX
The nurse is monitoring a client for signs of hypocalcemia after thyroidectomy. Which sign/symptom, if noted in the client, wouldmost likely indicate the presence of hypocalcemia? 1. Bradycardia 2. Flaccid paralysis 3. Tingling around the mouth 4. Absence of Chvostek's sign
3. Tingling around the mouth NCLEX
Graves' disease
common cause of hyperthyroidism
A patient has been diagnosed with hypothyroidism. What should the nurse expect to assess in this patient's integumentary system? a. Warm, flushed skin; alopecia; thin nails b. General hyperpigmentation and loss of body hair c. Pale skin; pale mucous membranes; hair loss; nail dystrophy d. Cold, dry, pale skin; dry, coarse hair; brittle, slow-growing nails
d. Cold, dry, pale skin; dry, coarse hair; brittle, slow-growing nails MS ch 22
TSH levels in hyperthyroidism
decreased
flash cards
https://www.freezingblue.com/flashcards/print_preview.cgi?cardsetID=256678
Cushing syndrome: cardiovascular symptoms (2)
-hypertension -lower extremity edema
hypothyroidism: integumentary symptoms (4)
-dry skin -cold skin -thick, brittle nails -dry, sparse, coarse hair
Cushing syndrome: musculoskeletal symptoms (4)
-extremity muscle wasting -back pain -weakness -fatigue
A registered nurse (RN) is caring for a client with a diagnosis of Cushing's syndrome. A nursing student is working with the RN for the day. Which statement by the student indicates understanding of Cushing's syndrome? 1. "Cushing's syndrome is caused by excessive amounts of cortisol." 2. "Cushing's syndrome is caused by decreased amounts of aldosterone." 3. "Cushing's syndrome is caused by excessive amounts of antidiuretic hormone." 4. "Cushing's syndrome is caused by decreased amounts of parathyroid hormone."
1. "Cushing's syndrome is caused by excessive amounts of cortisol." NCLEX
The nursing instructor asks a nursing student to identify the risk factors associated with the development of thyrotoxicosis. The student demonstrates understanding of the risk factors by identifying an increased risk for thyrotoxicosis in which client? 1. A client with hypothyroidism 2. A client with Graves' disease who is having surgery 3. A client with diabetes mellitus scheduled for a diagnostic test 4. A client with diabetes mellitus scheduled for débridement of a foot ulcer
2. A client with Graves' disease who is having surgery (stressors, like surgery, can cause a thyroid storm) NCLEX
The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client? 1. Dry skin 2. Bulging eyeballs 3. Periorbital edema 4. Coarse facial features
2. Bulging eyeballs (Hyperthyroidism is clinically manifested by goiter and exophthalmos (bulging eyeballs). Other clinical manifestations include nervousness, fatigue, weight loss, muscle cramps, and heat intolerance.) NCLEX
A client is diagnosed with Cushing's syndrome. The nurse plans care, knowing that this client has an excess of which substances? 1. Calcium 2. Cortisol 3. Epinephrine 4. Norepinephrine
2. Cortisol NCLEX
The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client? 1. "You can take either hydrocortisone or fludrocortisone for replacement." 2. "You need to take your fludrocortisone 3 times a day to prevent a crisis." 3. "You need to increase salt in your diet, particularly during stressful situations." 4. "You need to decrease your dosages of glucocorticoids and mineralocorticoids during stressful situations."
3. "You need to increase salt in your diet, particularly during stressful situations." NCLEX
The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which symptoms are associated with this diagnosis? Select all that apply. 1. Tremors 2. Weight loss 3. Feeling cold 4. Loss of body hair 5. Persistent lethargy 6. Puffiness of the face
3. Feeling cold 4. Loss of body hair 5. Persistent lethargy 6. Puffiness of the face NCLEX
hypercalcemia: Cushing syndrome or Addison's disease?
Addison's disease
hyperkalemia: Cushing syndrome or Addison's disease?
Addison's disease
Addison's disease
adrenal insufficiency, adrenocortical insufficiency (not enough cortisol), adrenal hypofunction
Cushing's syndrome
adrenal overproduction, hypercortisolism (too much cortisol), adrenal hyperfunction
goiter: hypothyroidism or hyperthyroidism?
hyperthyroidism
myxedema coma causes
stressors (ex: illness, surgery)
thyroid storm causes
stressors (ex: infection, trauma, surgery)
Cushing syndrome: hallmark symptoms (3)
-centripetal obesity (truncal obesity) -moon face (round face) -buffalo hump (fat deposits on back of neck and shoulders)
Addison's disease: electrolytes (3)
-hyperkalemia -hypercalcemia -hyponatremia
hypoparathyroidism: electrolytes
-hypocalcemia -hyperphosphatemia
Addison's disease: cardiovascular symptoms (2)
-hypotension -tachycardia
temperature intolerance: hypothyroidism vs hyperthyroidism
-hypothyroidism = cold intolerance -hyperthyroidism = heat intolerance
GI disturbances: hypothyroidism vs hyperthyroidism
-hypothyroidism = constipation -hyperthyroidism = diarrhea
weight changes: hypothyroidism vs hyperthyroidism
-hypothyroidism = weight gain -hyperthyroidism = weight loss
The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which assessment finding should the nurse expect to note in this client? 1. Dry skin 2. Thin, silky hair 3. Bulging eyeballs 4. Fine muscle tremors
1. Dry skin NCLEX
A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. 1. Fever 2. Nausea 3. Lethargy 4. Tremors 5. Confusion 6. Bradycardia
1. Fever 2. Nausea 4. Tremors 5. Confusion (symptoms of a thyroid storm) NCLEX
A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? (Select all that apply) 1. Hypotension 2. Leukocytosis 3. Hyperkalemia 4. Hypercalcemia 5. Hypernatremia
1. Hypotension 3. Hyperkalemia NCLEX
A client with suspected primary hyperparathyroidism is undergoing diagnostic testing. Which client complaint would be characteristic of this disorder? (Select all that apply) 1. Polyuria 2. Headache 3. Bone pain 4. Nervousness 5. Weight gain
1. Polyuria 3. Bone pain NCLEX
normal TSH level
2-10 mcU/L
A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which statement should the nurse make to the client? 1. "Don't be concerned; this problem can be covered with clothing." 2. "Usually these physical changes slowly improve following treatment." 3. "This is permanent, but looks are deceiving and are not that important." 4. "Try not to worry about it; there are other things to be concerned about."
2. "Usually these physical changes slowly improve following treatment." NCLEX
A client visits the health care provider's office for a routine physical examination and reports a new onset of intolerance to cold. Since hypothyroidism is suspected, which additional information would be noted during the client's assessment? 1. Weight loss and tachycardia 2. Complaints of weakness and lethargy 3. Diaphoresis and increased hair growth 4. Increased heart rate and respiratory rate
2. Complaints of weakness and lethargy NCLEX
A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). The nurse plans care for the client, anticipating that he or she may have a deficiency of which dietary elements? 1. Calcium 2. Iodine 3. Phosphorus 4. Magnesium
2. Iodine NCLEX
The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome. Which laboratory finding would the nurse expect to note in this client? 1. A platelet count of 200,000 cells/mm3 2. A blood glucose level of 110 mg/dL 3. A potassium (K+) level of 5.5 mEq/L 4. A white blood cell (WBC) count of 6000 cells/mm3
3. A potassium (K+) level of 5.5 mEq/L (Cushing's = hyperglycemia, hyperkalemia, elevated WBC) NCLEX
A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? 1. Hypoglycemia 2. Level of hoarseness 3. Respiratory distress 4. Edema at the surgical site
3. Respiratory distress NCLEX
The nurse is caring for a client after thyroidectomy. The nurse notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which purpose? 1. To treat thyroid storm 2. To prevent cardiac irritability 3. To treat hypocalcemic tetany 4. To stimulate release of parathyroid hormone
3. To treat hypocalcemic tetany NCLEX
The nurse is caring for a client with a diagnosis of Addison's disease. The nurse is monitoring the client for signs of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis? 1. Agitation 2. Diaphoresis 3. Restlessness 4. Severe abdominal pain
4. Severe abdominal pain NCLEX
hypotension: Cushing syndrome or Addison's disease?
Addison's disease
skin hyperpigmentation: Cushing syndrome or Addison's disease?
Addison's disease
weight loss: Cushing syndrome or Addison's disease?
Addison's disease
salt craving: Cushing syndrome or Addison's disease?
Addison's disease (hyponatremia)
The nurse is caring for a patient admitted with suspected hyperparathyroidism. Which signs and symptoms would represent the expected electrolyte imbalance (select all that apply.)? a. Nausea and vomiting b. Neurologic irritability c. Lethargy and weakness d. Increasing urine output e. Hyperactive bowel sounds
a. Nausea and vomiting c. Lethargy and weakness d. Increasing urine output (symptoms of hypercalcemia) MS
A nurse is planning care for a pt who has Cushing's disease. The nurse should recognize that pts who have Cushing's disease are at increased risk for which of the following? (Select all that apply) a. infection b. gastric ulcer c. renal calculi d. bone fractures e. dysphagia
a. infection b. gastric ulcer d. bone fractures ATI
A nurse is reviewing laboratory results for a pt who has Addison's disease. Which of the following laboratory studies should the nurse expect for this pt? (Select all that apply) a. sodium 130 mEq/L b. potassium 6.1 mEq/L c. calcium 11.6 mg/dL d. BUN 28 mg/dL e. fasting blood glucose 148 mg/dL
a. sodium 130 mEq/L b. potassium 6.1 mEq/L c. calcium 11.6 mg/dL d. BUN 28 mg/dL (Addison's = hyponatremia, hyperkalemia, hypercalcemia, ↑BUN secondary to dehydration) ATI
A nurse is reviewing the laboratory findings of a pt who has Cushing's disease. Which of the following findings should the nurse expect for this pt? (Select all that apply) a. sodium 150 mEq/L b. potassium 3.3 mEq/L c. calcium 8.0 mg/dL d. lymphocyte count 35% e. fasting glucose 145 mg/dL
a. sodium 150 mEq/L b. potassium 3.3 mEq/L c. calcium 8.0 mg/dL e. fasting glucose 145 mg/dL (Cushing's = hypernatremia, hypokalemia, hypocalcemia, hyperglycemia) ATI
A pt has been diagnosed with hypoparathyroidism. What manifestations should the nurse expect to observe? (Select all that apply) a. skeletal pain b. dry, scaly skin c. personality changes d. abdominal cramping e. cardiac dysrhythmias f. muscle spasms and stiffness
b. dry, scaly skin c. personality changes d. abdominal cramping e. cardiac dysrhythmias f. muscle spasms and stiffness (symptoms of hypocalcemia) MS workbook
What should be included in the interprofessional plan of care for a patient with Cushing disease? a. Lab monitoring for hyperkalemia b. Vital sign monitoring for hypotension c. Counseling related to body image changes d. Diet consultation to determine low protein choices
c. Counseling related to body image changes (obesity, moon face, buffalo hump) MS
A patient who smokes reports having significant stress and is experiencing eye problems. On assessment, the nurse notes exophthalmos. What additional abnormal findings should the nurse assess for? a. Muscle weakness and slow movements b. Puffy face, decreased sweating, and dry hair c. Systolic hypertension and increased heart rate d. Decreased appetite, increased thirst, and pallor
c. Systolic hypertension and increased heart rate (symptoms of hyperthyroidism) MS
After thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the pt develops: a. muscle weakness and weight loss b. hyperthermia and severe tachycardia c. hypertension and difficulty swallowing d. laryngospasms and tingling in the hands and feet
d. laryngospasms and tingling in the hands and feet (symptoms of hypocalcemia) MS
exophthalmos
hyperthyroidism - bulging eyes
thyroid storm
hyperthyroidism - sudden surge of thyroid hormones into the bloodstream
myxedema coma
hypothyroidism - life-threatening condition that occurs when hypothyroidism is untreated or when a stressor affects a pt with hypothyroidism
myxedema
hypothyroidism - puffiness and edema around eyes and face (periorbital edema)
menstrual irregularities: hypothyroidism or hyperthyroidism?
hypothyroidism: amenorrhea (abnormal absence of menstrual period)
T4 levels in hyperthyroidism
increased
TSH levels in hypothyroidism
increased
hypothyroidism: cardiovascular symptoms (3)
-bradycardia -hypotension -decreased cardiac output
The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs or symptoms, if noted in the client, will alert the nurse to the presence of this crisis? 1. Fever and tachycardia 2. Pallor and tachycardia 3. Agitation and bradycardia 4. Restlessness and bradycardia
1. Fever and tachycardia NCLEX
The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs should the nurse monitor for? Select all that apply. 1. Anorexia 2. Dizziness 3. Hypertension 4. Weight loss 5. Moon face 6. Truncal obesity
3. Hypertension 5. Moon face 6. Truncal obesity NCLEX
The following are symptoms of hyperthyroidism: (select all that apply) a. insomnia b. heat intolerance c. weight loss d. dry skin e. bradycardia
a. insomnia b. heat intolerance c. weight loss quiz
Which are the physical findings of Cushing's syndrome? (select all that apply) a. truncal obesity b. "moon-faced" appearance c. extremity muscle wasting d. thin, easily damaged skin e. excessive sweating
a. truncal obesity b. "moon-faced" appearance c. extremity muscle wasting d. thin, easily damaged skin quiz
A pt with Addison's disease comes into the ED with complaints of nausea, vomiting, diarrhea, and fever. What interprofessional care should the nurse expect? a. IV administration of vasopressors b. IV administration of hydrocortisone c. IV administration of D5W with 20 mEq KCl d. parenteral injections of adrenocorticotropic hormone (ACTH)
b. IV administration of hydrocortisone (symptoms of Addisonian crisis) MS workbook
The patient in the emergency department after a car accident is wearing medical identification listing Addison's disease. What should the nurse expect to be included in the care of this patient? a. Low-sodium diet b. Increased glucocorticoid replacement c. Limiting IV fluid replacement therapy d. Withholding mineralocorticoid replacement
b. Increased glucocorticoid replacement MS
A nurse is reviewing the laboratory results of a pt who is being evaluated for secondary hypothyroidism. Which of the following laboratory findings is expected for a pt who has this condition? a. elevated serum T4 b. decreased serum T3 c. elevated serum thyroid stimulating hormone d. decreased serum cholesterol
b. decreased serum T3 (secondary hypothyroidism = ↓T3, ↓T4, ↓TSH) ATI
A nurse is reviewing the record of a client who is being evaluated for Graves' disease. The nurse should identify that which of the following laboratory results is an expected finding? a. decreased thyrotropin receptor antibodies b. decreased thyroid-stimulating hormone (TSH) c. decreased free thyroxine index d. decreased triiodothyronine
b. decreased thyroid-stimulating hormone (TSH) ATI
A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? (Select all that apply) a. anorexia b. heat intolerance c. constipation d. palpitations e. weight loss f. bradycardia
b. heat intolerance d. palpitations e. weight loss hyperthyroidism also causes: -increased appetite -diarrhea -tachycardia ATI
A nurse is collecting an admission history from a female client who has hypothyroidism. Which of the following findings should the nurse expect? (Select all that apply) a. diarrhea b. menorrhagia c. dry skin d. increased libido e. hoarseness
b. menorrhagia (abnormally heaving bleeding at menstruation) c. dry skin e. hoarseness ATI
Important nursing interventions when caring for a pt with Cushing syndrome include (select all that apply): a. restricting protein intake b. monitoring blood glucose levels c. observing for signs of hypotension d. administering medication in equal doses e. protecting pt from exposure to infection
b. monitoring blood glucose levels e. protecting pt from exposure to infection (Cushing syndrome = hyperglycemia, inhibition of immune response) MS
Pt is postoperative after thyroidectomy. She reports incisional pain as a 4/10. Vitals: T 98 F, P 88, R 14, BP 110/72. Breath sounds are clear bilaterally. Her IV is infusing at 125 mL/hr. Which assessment is most important for the nurse to complete next? a. measure urinary output b. observe neck dressing c. palpate pedal pulses d. obtain oxygen saturation
b. observe neck dressing -vitals are WNL -hemorrhage at surgical site
Which assessment findings would indicate the possible onset of a thyroid storm? a. numbness and tingling in both arms b. tachycardia, fever, and altered mental state c. pain and a hoarse voice d. respiratory stridor
b. tachycardia, fever, and altered mental state
Addison's disease: integumentary symptoms (1)
skin hyperpigmentation (bronze)
hyperparathyroidism: electrolytes
-hypercalcemia -hypophosphatemia
thyroid storm symptoms (6)
-hyperthermia/fever -tachycardia -heart failure -delirium/confusion -abdominal pain -vomiting, diarrhea
Cushing syndrome: electrolytes (3)
-hypokalemia -hypocalcemia -hypernatremia
CNS: hypothyroidism vs hyperthyroidism
-hypothyroidism = fatigue, lethargy, forgetfulness -hyperthyroidism = nervousness, tremors, irritability, restlessness
myxedema coma interventions (5)
-maintain patent airway -cardiac monitoring -administer thyroid hormones (levothyroxine) -warm blankets (hypothermia) -hydration with 0.9% sodium chloride
thyroid storm interventions (8)
-maintain patent airway -cardiac monitoring for dysrhythmias -acetaminophen to decrease temperature -cool sponge baths, ice packs, cooling blanket -administer thionamides (propylthiouracil) -administer sodium iodine -administer beta blockers (SNS effects) -supplemental oxygen
hyperthyroidism: integumentary symptoms (4)
-moist skin -warm skin -thin, brittle nails -hair loss
Addisonian crisis symptoms (5)
-severe headache -severe abdominal pain -severe hypotension -confusion, irritability -weakness
Addison's disease: hallmark symptoms (4)
-skin hyperpigmentation (bronze) -weight loss -weakness -fatigue
hyperthyroidism: cardiovascular symptoms (4)
-tachycardia -hypertension -palpitations -dysrhythmias
A 33-year-old female client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment? 1. Amenorrhea 2. Menorrhagia 3. Metrorrhagia 4. Dysmenorrhea
1. Amenorrhea (abnormal absence of menstrual period) Graves' disease = hyperthyroidism NCLEX
The nurse is assessing a client who has a diagnosis of goiter. Which should the nurse expect to note during the assessment of the client? 1. An enlarged thyroid gland 2. The presence of heart damage 3. Client complaints of chronic fatigue 4. Client complaints of slow wound healing
1. An enlarged thyroid gland NCLEX
The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client? 1. Hypotension and fever 2. Mental status changes and hypertension 3. Subnormal temperature and hypotension 4. Complaints of weakness and hypertension
1. Hypotension and fever NCLEX
A client with an endocrine disorder has experienced recent weight loss and exhibits tachycardia. The nurse plans care, knowing that which gland is most likely to be responsible for these findings? 1. Thyroid 2. Pituitary 3. Parathyroid 4. Adrenal cortex
1. Thyroid NCLEX
The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood? 1. "I will need to limit the amount of protein in my diet." 2. "I should eat foods that have a lot of potassium in them." 3. "I am fortunate that I can eat all the salty foods I enjoy." 4. "I am fortunate that I do not need to follow any special diet."
2. "I should eat foods that have a lot of potassium in them." NCLEX
A client is admitted to the emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse carry out initially? 1. Warm the client 2. Maintain a patent airway 3. Administer thyroid hormone 4. Administer fluid replacement
2. Maintain a patent airway (ABCs) NCLEX
The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply: 1. Provide a cool environment for the client. 2. Instruct the client to consume a high-fat diet. 3. Instruct the client about thyroid replacement therapy 4. Encourage the client to consume fluids and high-fiber foods in the diet 5. Inform the client that iodine preparations will be prescribed to treat the disorder 6. Instruct the client to contact the healthcare provider if episodes of chest pain occur
3. Instruct the client about thyroid replacement therapy 4. Encourage the client to consume fluids and high-fiber foods in the diet 6. Instruct the client to contact the healthcare provider if episodes of chest pain occur NCLEX
A nursing assessment of a patient with Cushing syndrome reveals that the patient has truncal obesity and thin arms and legs. An additional manifestation of Cushing syndrome that the nurse would expect to find includes 1. hypotension. 2. decreased axillary and pubic hair. 3. purplish red streaks on the abdomen. 4. bronzed hyperpigmentation of the skin.
3. purplish red streaks on the abdomen. (striae is common in Cushing's)
A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment upon finding 1. decreasing blood glucose. 2. increasing urinary output. 3. decreasing serum sodium. 4. decreasing serum potassium.
4. decreasing serum potassium. (Addison's = hypoglycemia, hyponatremia, hyperkalemia)
A patient with Graves' disease is prepared for surgery with drug therapy consisting of 4 weeks of propylthiouracil (PTU) and 10 days of iodine before surgery. When teaching the patient about the drugs, the nurse explains that the drugs are given preoperatively to: 1. eliminate the risk for postoperative tetany. 2. decrease the risk of hypometabolism during and after the surgery. 3. assist in locating the thyroid and parathyroid glands during surgery. 4. normalize metabolism and decrease the size and vascularity of the gland.
4. normalize metabolism and decrease the size and vascularity of the gland.
Which assessment finding would the nurse expect in a patient who has been taking oral prednisone several weeks and is experiencing sudden withdrawal (select all that apply.)? a. BP 80/50 b. Heart rate 54 c. Glucose 63 mg/dL d. Sodium 148 mEq/L e. Potassium 6.3 mEq/L f. Temperature 101.1° F
a. BP 80/50 c. Glucose 63 mg/dL e. Potassium 6.3 mEq/L f. Temperature 101.1° F (symptoms of adrenal insufficiency: hypotension, tachycardia, hypoglycemia, hyponatremia, hyperkalemia, fever) MS
A pt is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the pt, what should the nurse expect to find? a. hypertension, peripheral edema, and petechiae b. weight loss, buffalo hump, and moon face with acne c. abdominal and buttock striae, truncal obesity, and hypotension d. anorexia, signs of dehydration, and hyperpigmentation of the skin
a. hypertension, peripheral edema, and petechiae MS workbook
A nurse in an intensive care unit is planning care for a pt with myxedema coma. Which of the following actions should the nurse include? (Select all that apply) a. observe cardiac monitor for dysrhythmias b. observe for evidence of a UTI c. initiate IV fluids using 0.9% sodium chloride d. provide warmth using a heating pad
a. observe cardiac monitor for dysrhythmias b. observe for evidence of a UTI c. initiate IV fluids using 0.9% sodium chloride (provide warmth using blankets, not electric heating devices) ATI
A nurse is preparing to receive a client from the PACU who is postoperative following a thyroidectomy. The nurse should ensure that which of the following equipment is available? (Select all that apply) a. suction equipment b. humidified oxygen c. flashlight d. tracheostomy tray e. chest tube tray
a. suction equipment b. humidified oxygen d. tracheostomy tray (respiratory obstruction is major complication of thyroidectomy) ATI
The nurse is caring for a patient recently started on levothyroxine for hypothyroidism. What information reported by the patient requires immediate action? a. Weight gain or weight loss b. Chest pain and palpitations c. Muscle weakness and fatigue d. Decreased appetite and constipation
b. Chest pain and palpitations (Levothyroxine is used to treat hypothyroidism - chest pain and palpitations are symptoms of hyperthyroidism) MS
You are going into assess a new patient admitted for Pneumonia and a decreased level of consciousness. After reviewing the chart you identify that the patient has a history of hypothyroidism and identify that her T3 & T4 levels are extremely low. The nurse anticipates an order to immediately: a. administer IV morphine b. administer IV thyroid hormone replacement c. administer cooling measures d. administer IV calcium gluconate
b. administer IV thyroid hormone replacement
Which of the following is a diagnosis that might be included in the plan of care for a pt with hypothyroidism? a. hyperthermia b. decreased cardiac output c. altered nutrition, less than body requirements d. diarrhea
b. decreased cardiac output (hypothyroidism = hypothermia, constipation)
A nurse is assessing a client who is 12 hr postoperative following a thyroidectomy. The nurse should identify which of the following findings as indicative of thyroid crisis? (Select all that apply) a. bradycardia b. hypothermia c. dyspnea d. abdominal pain e. mental confusion
c. dyspnea d. abdominal pain e. mental confusion ATI
A pt is admitted to the hospital with acute thyrotoxicosis. On physical assessment of the pt, what should the nurse expect to find? a. hoarseness and laryngeal stridor b. bulging eyeball and dysrhythmias c. elevated temperature and signs of heart failure d. lethargy progressing suddenly to impairment of consciousness
c. elevated temperature and signs of heart failure MS workbook
What medication is used with thyrotoxicosis to block the effects of the sympathetic nervous system stimulation of the thyroid hormones? a. potassium iodine b. propylthiouracil c. propranolol d. radioactive iodine (RAI)
c. propranolol MS workbook
