Test 2
the manifestations of a patient with hyperthyroidism
(Everything high) irritable, sensitive to heat, weightloss, restlessness, smooth silky hair, Diarrhea , hyperactive bowel sounds
What does the parathyroid regulate
(think electrolyte) CALCIUM LEVEL
Treating hypocalcemic tetany
1)Position patient for optimal ventilation; remove pillow to prevent head from bending forward and compressing trachea.2)Keep side rails padded and elevated in a position to prevent the patient injury if seizure occurs do not use restraints.3)Have equipment available to treat respiratory difficulties that include airway suction equipment tracheostomy and cardiac arrest equipment.4)Administer IV calcium as directed
Mag
1.3-2.1
Sodium (Na)
135-145 mEq/L
ca
9-10.5
A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?
A client who has a phosphate of 5.7 mg/dL
While a 68-year-old woman is hospitalized for a fractured femur, she is diagnosed with hypothyroidism. Which of the following medications ordered for the patient at the time of admission does the nurse recognize should not be administered without consulting the physician?
A sedative
A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. What intervention would the nurse anticipate?
Administration of intravenous calcium gluconate
Following a thyroidectomy, the patient develops hypoparathyroidism. The nurse teaches the patient that maintenance therapy for the hypoparathyroidism will include which of the following
Calcium supplements
A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan
Check the client's voice every 2 hr.
Know what the manifestations of hypocalcemia are
Chvostek Trousseau sign TETANY! paresthesia of the fingers and lips
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?
Chvostek's sign
When admitting a patient who has just recently fallen and broken his hip, the nurse notes hypertension, muscle wasting, and a large buffalo hump. The nurse knows that these findings are consistent with the patient having which following diagnosis?
Cushings
Which of the following effects on the cardiovascular system would a patient with a hypofunction of the parathyroid gland most likely exhibit?
Decreased contractility of heart muscle
4.A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results?
Decreased thyroid-stimulating hormone (TSH) level
What medication is used to treat Cushing's
Diuretics ( aldactone- potassium sparring)Alosterone blocking agent
What are the manifestations of hypothyroidism
Everything is low weight gain, dry skin, intolerance to cold, swelling of face hands and feet, brittle nails bradycardia, constipated
What would you add to the diet of someone with hypothyroidism to prevent constipation?
FLUIDS AND FIBER
Know the position of choice following a thyroidectomy.
Fowlers
Know what is given to treat hypocalcemia.
GIVE CALCIUM
In a thyroidectomy, the parathyroid gland is usually spared in order to prevent
HYPOCALCEMIA
Calcium level monitoring in the post operative patient
If within 48 hours levels fall below 7mg/100mL, IV calcium is given IV calcium is used cautiously
cushing disesase diet
Increased potassium decreased sodium
While assessing a patient who has just arrived in the postanaesthesia recovery unit after a thyroidectomy, the nurse obtains the following data. Which information is most important to communicate to the surgeon
Increasing swelling of the neck
Signs of hypocalcemia in the post operative patient
Irritability, twitching, spasms of the hands and feet CHOVESK, MUSCLE TETANY,
A patient with hyperthyroidism is treated with radioactive iodine at a clinic. Before the patient is discharged, what should the nurse instruct the patient about?
Monitoring for symptoms of hypothyroidism, such as easy bruising and cold intolerance
4.A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism or Cushings Syndrome
Moon Face
Know what would be decreased in a patient's diet with Cushing's disease.
Reduce sodium, increase vitamin d and calcium, control blood sugar, increase potassium and protein
6.A nurse is caring for a client who is 8 hr postoperative following a subtotal thyroidectomy. In which of the following positions should the nurse keep the client?
Semi-Fowler's with neck in a neutral position
Know what laboratory tests would be done in a patient with hypothyroidism.
T3 T4
Know what hormones are produced by the thyroid gland.
T3, T4 thyroxine
Watch for the development of _________Caused by the removal or disturbance of the parathyroid glands
TETANY
what would your priority be in a patient that has had a thyroidectomy.
Think ABC's Protect the airway, check the respirations
A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?
Tingling of the extremities
A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?
Verify the most recent calcium level.
Know what vitamin regulates calcium levels in the body.
Vitamin D
Know the interventions the nurse would perform in a patient with Cushing's disease what would you assess and monitor.
blood glucose level will be elevated, check weight, check neck vein distention,
Know what electrolyte would be elevated in a patient with hyperparathyroidism.
calcium
What does parathyroid hormone do/ regulate
calcium
what would be monitored in a patient receiving glucocorticosteriods and what adverse effects you may see.
check face, could develop moon face buffalo hump trunkle obesity
Know what you would do in a patient that is post-op following a thyroidectomy that complains of muscle spasms.
check pt. calcium level
Know when you would change a dressing in a post-op patient following a hypophysectomy.
drainage, change if it saturated
what would be monitored in a post-op patient with Addison's disease
drop in blood pressure after surgery ADDISONIAN CRISIS
Know what you would assess in an immediate post-op patient before giving foods or fluids.
gag reflex, bowel sounds
Know the treatments for hypothyroidism.
hormone replacements
removal of the pituitary gland
hypophysectomy
Glucocorticoids (cortisol) affects glucose, protein, and fat metabolism; the body's response to stress; and the body's ______ function.
immune
if patient complains of bein cold, weight gain, and always tired
lab test T3, T4
what the complications of hyperparathyroidism.
magnesium levels calcium
Know what the function of the thyroid gland is.
metabolism
3 manifestations of cushings
moon face buffalo hump purple striae
Know what is secreted by the anterior and posterior pituitary glands.
oxytocin vasopresin
Addison's disease pt. can have
salt
Know what is encouraged to decrease simple goiter. IF PT HAS LOW IODINE PT COULD HAVE
table salt IODINE SIMPLE GOITER
removal of pituitary gland how would sx be performed
through the nose
why you would measure thyroid stimulating hormone level.
thyroid that is produced by the pituitary to stimulate the thyroid.
Know the manifestations of hypoparathyroidism
tingling, numbness of hands
Know the manifestations of Cushing's disease
weakness, fatigue, sleep disturbances, back and joint pain, decreased libido, decreased immune function, bone pain and fracture due to osteoporosis, increases hair growth,Excessive Hair Growth is called Hirsutism)
pt that has hypothyroidism pt will have
weight gain
