Drug Therapy for Hyperthyroidism and Hypothyroidism

When learning about thyroid hormones in pharmacology, the nursing students learn that when the thyroid gland is stimulated by thyroid-stimulating hormone (thyrotropin or TSH) from the anterior pituitary gland, thyroid hormones are: a. stored in the thyroid gland. b. released into the bloodstream. c. released into the lymphatic system. d. stored in the parathyroid glands.

released into the bloodstream. Explanation: Thyroid hormones are released into the circulation when the thyroid gland is stimulated by thyroid-stimulating hormone (thyrotropin or TSH) from the anterior pituitary gland.

A client suffering from severe hyperthyroidism is preparing to undergo thyroidectomy surgery after failing the iodine radiation therapy. The health care provider has already been in the room to explain the procedure and answer any questions the client may have had. Which statement by the client best exhibits that the client requires further teaching regarding the procedure? a. "I will need to have not had anything to eat or drink at least 8 hours prior to my surgery." b. "I will no longer require iodine radiation therapy treatments." c. "I am looking forward to the surgery because it will cure my hyperthyroidism and eliminate the need for medication." d. "The surgeon will attempt to remove my entire thyroid gland."

"I am looking forward to the surgery because it will cure my hyperthyroidism and eliminate the need for medication." Explanation: While the client will no longer be in a hyperthyroid state, removing the thyroid gland will put the client in a hypothyroid state. Without a functioning thyroid, the client will be placed on thyroid supplements for the remainder of their life. Therefore, the client stating that the procedure will eliminate the need for medication is incorrect and requires further teaching. The client is correct in stating that they will need to not have had anything to eat or drink for at least 8 hours prior to the procedure. The client is correct in stating that the surgeon will attempt to remove the entire thyroid gland. The client is also correct in stating they will no longer require iodine radiation therapy treatments. They will instead require thyroid supplements.

A nurse is educating a client newly diagnosed with hypothyroidism on their treatment plan. The nurse is explaining to the client that the health care provider is prescribing levothyroxine to help manage the client's condition and begins a teaching session regarding the new medication. Which statement by the client best exhibits that the nurse's teaching was successful? a. "I should take my levothyroxine every day in the morning on an empty stomach." b. "I can switch to a generic brand of levothyroxine if it's more affordable at the pharmacy." c. "I should take my levothyroxine with a glass of milk to help it go down easier." d. "I can skip a dose if I start feeling better and my symptoms improve."

"I should take my levothyroxine every day in the morning on an empty stomach." Explanation: It is important to take levothyroxine on an empty stomach every day in the morning. This statement indicates a clear understanding of the correct administration of levothyroxine. Levothyroxine is typically prescribed for long-term management of hypothyroidism. Stopping or skipping doses without consulting the health care provider is not recommended and is, therefore, an incorrect statement. Levothyroxine should be taken with a full glass of water, not milk or other beverages, as some substances can interfere with its absorption. The decision to switch to a generic brand should be discussed with the health care provider, as not all formulations of levothyroxine are equivalent, and changes in medication should be made under medical supervision, which would make this an incorrect statement.

The nurse is caring for a 55-year-old client with Hashimoto's thyroiditis. During discharge teaching, which statement by the client tells the nurse the client understands the teaching? a. "If I feel nauseated, I may take this drug with an antacid." b. "I may use the generic brand if I can find it cheaper than the one prescribed." c. "I can take this medication any time of day." d. "I should take this medication on an empty stomach in the morning."

"I should take this medication on an empty stomach in the morning." Explanation: Adults who require thyroid replacement therapy need to understand that this will be a life-long replacement need. An established routine of taking the tablet first thing in the morning may help the client comply with the drug regimen.

A nurse working on the acute-care medical surgical floor is preparing to discharge a client diagnosed with hyperthyroidism. The health care provider is prescribing methimazole 25 mg/day orally, divided doses at 8-hour intervals. Which statement by the client best exhibits that the discharge teaching for the new prescription was successful? a. "The dosage of my medication will never increase or decrease." b. "I will take the methimazole once a day with breakfast to make it easier to remember." c. "I will most likely not see improvement in my condition for at least 3 to 4 weeks." d. "Symptoms such as increased heart rate and heavy breathing are normal with this medication."

"I will most likely not see improvement in my condition for at least 3 to 4 weeks." Explanation: Antithyroid drugs, such as methimazole, work by inhibiting the manufacture of thyroid hormones. They do not affect the existing thyroid hormones that are already circulating in the bloodstream. For this reason, the statement by the client that they may not see improvement in their condition for at least 3 to 4 weeks is the most appropriate response to exhibit that the client understood the teaching for their new medication. The statement by the client that they will take the medication once a day with breakfast is incorrect because methimazole should be taken every 8 hours, not just once per day. Common symptoms experienced with methimazole are numbness, headache, loss of hair, skin rash, nausea, and vomiting, as opposed to the symptoms of increased heart rate and heavy breathing that the client stated. The statement that the dosage of the medication will never increase or decrease is incorrect as well. The client will need to periodically have their thyroid-stimulating hormone blood levels checked to make sure the methimazole dosing is adequate.

The nurse educates a client recently diagnosed with hypothyroidism about using the prescribed levothyroxine. The client has a history of diabetes. Which client statement establishes the need for further clarification? a. "I will take the drug thirty minutes before breakfast the same time each day." b. "The levothyroxine can increase my glucose, so I need to report hyperglycemia." c. "Thyroid replacement is lifelong; dosage changes must come from my provider." d. "It does not matter which brand of the drug I take, they are all the same."

"It does not matter which brand of the drug I take, they are all the same." Explanation: The nurse needs to clarify with further teaching the client's statement that it does not matter what brand of levothyroxine is taken. The client needs to keep taking the same brand because switching brands can lead to changes in the hormone level and affect the treatment. The other statements made by the client support an adequate understanding of various teaching points. Taking the drug before breakfast allows the medication to dissolve and be absorbed on an empty stomach. Taking the medication at the same time of day helps to maintain a steady state of the drug. Thyroid replacement may cause symptoms of diabetes to increase, so monitoring for hyperglycemia is warranted since the client has a history of diabetes. Thyroid replacement in this case is lifelong, and the client should not intentionally change a dose by increasing, decreasing, or skipping a dose.

An adult client has been diagnosed with hypothyroidism and is expected to receive a prescription for levothyroxine shortly. The client asks the nurse, "How long do you think I'll have to take the medication for?" What is the nurse's best response? a. "You will likely need to take the medication for the rest of your life." b. "Your provider will likely prescribe the medication until your symptoms are stable for 6 weeks." c. "The length of treatment varies for every client, but 9 to 12 months is typical." d. "The length of treatment will largely depend on the results of your blood work."

"You will likely need to take the medication for the rest of your life." Explanation: Calibrating the dose of levothyroxine will depend on symptoms and laboratory results, but there is normally a lifelong need to continue taking the medication.

Levothyroxine (Synthroid) 88 mcg is prescribed for a client. How many mg of Synthroid will the nurse administer? Do NOT round the answer.

0.088 Explanation: 1 mg = 1000 mcg. 88 mcg = 0.088 mg

An adult client has been diagnosed with hypothyroidism and has been prescribed an initial dose of PO levothyroxine of 1.7 mcg/kg/day. The hospital nurse obtains a weight of 130 lb and would obtain levothyroxine in which available dose from the pharmacy? a. 88 mcg b. 25 mcg c. 100 mcg d. 50 mcg e. 112 mcg f. 75 mcg

100 mcg Explanation: The client's weight must first be converted to kilograms: 130/2.2 = 59.1 kg. The prescribed dose is 1.7 mcg/kg, and 1.7 X 59.1 = 100.5 mcg. The most appropriate delivery of the medication would consequently be 100 mcg.

Methimazole (Tapazole) 30 mg /day orally divided in 3 doses is prescribed for a client diagnosed with Graves' disease. The pharmacy has 5 mg tablets available. How many tablets should the nurse administer with each dose?

2 Explanation: 30 mg/day divided in 3 doses = 10 mg/dose; 10 mg / 5 mg tablets = 2 tablets per dose

A client with symptomatic hyperthyroidism is prescribed propranolol. Which clinical manifestation would the nurse identify that indicates the medication is having the desired effect? a. Profuse diaphoresis b. A blood pressure of 160/92 c. A heart rate of 72 beats/min d. A blood glucose of 86 mg/dL

A heart rate of 72 beats/min Explanation: Propranolol is recommended for use in all clients with symptomatic hyperthyroidism because it blocks beta-adrenergic receptors in various organs and thereby controls symptoms of hyperthyroidism resulting from excessive stimulation of the sympathetic nervous system. Since tachycardia is associated with hyperthyroidism, a heart rate of 72 beats/min indicates that the drug is having the desired effect. Profuse diaphoresis indicates that the medication is not effective or having the desired effect intended. The blood glucose is not affected by the propranolol use. The blood pressure of this client is not well controlled and still considered hypertensive.

A client presents to the clinic for a routine visit. The nurse suspects the client is experiencing hypothyroidism based on which assessment finding(s)? Select all that apply. a. Elevated body temperature b. Hypertension c. Bradycardia d. Sleepiness e. Weight gain

Bradycardia; Sleepiness; Weight gain Explanation: The signs and symptoms of hypothyroidism include decreased metabolism; cold intolerance; low body temperature (not elevated); weight gain; bradycardia; hypotension (not hypertension); lethargy; sleepiness; pale, cool, dry skin; face appearing puffy; coarse hair; thick, hard nails; heavy menses; fertility problems; and low sperm count.

The nurse is caring for an older adult client who has diagnoses of heart failure, hypertension, and hypothyroidism. The client's 8 a.m. medications include levothyroxine 125 mcg PO and the nurse's preadministration assessment reveals a heart rate of 89 beats/min, blood pressure of 136/86 mm Hg, SaO2 94%, respiratory rate 21 breaths/min and an oral temperature 35.8°C (96.4°F). What is the nurse's best action? a. Report the assessment findings to the health care provider. b. Administer the medication and reassess in one hour. c. Administer the medication with lunch rather than breakfast. d. Hold the medication and reassess the client in 30 minutes.

Administer the medication and reassess in one hour. Explanation: Levothyroxine must be used with caution in older adults with cardiovascular disease since it increases cardiac workload. However, this client's vital signs are not outside of reference ranges. Consequently, it is appropriate to administer the medication, following up with a reassessment afterward. Because the vital signs are not atypical, there is no compelling reason to delay the medication or report promptly to the health care provider.

A client is prescribed methimazole for the treatment of hyperthyroidism. Which is a rare adverse effect or set of effects related to the administration of methimazole? a. Arthralgia b. Joint swelling with fever c. Agranulocytosis d. Immune-mediated hyperthyroidism

Agranulocytosis Explanation: The rare but fatal adverse effects of methimazole are agranulocytosis, which affects only 0.2% to 0.5% of all people taking antithyroid medication; aplastic anemia; liver damage; and vasculitis. On the other hand, arthralgia, joint swelling, itching, rash, fever, hives, headaches, nausea, and vomiting are common, minor adverse effects of the drug. However, methimazole is used to treat immune-mediated hyperthyroidism of Graves disease, and it is not an adverse effect of the drug.

A client presents to the emergency department with an apparent reaction to recently started thyroid therapy. Which assessment finding would lead the nurse to question that this client is experiencing a thyroid storm? a. Cold intolerance b. Constipation c. Memory impairment d. Altered mental status

Altered mental status Explanation: Some clients will experience an increase in hyperthyroidism rather than decrease during therapy. When these symptoms occur rapidly, it is termed a thyrotoxic crisis or thyroid storm. It is characterized by high fever, extreme tachycardia, and altered mental status. Memory impairment, cold intolerance, and constipation are the manifestations of myxedema, which is a severe form of hypothyroidism.

A nurse is preparing to administer levothyroxine to a client. Which sign(s) or symptom(s) would the nurse expect to document on the preadministration assessment? Select all that apply. a. Nervousness b. Anorexia c. Tachycardia d. Cold intolerance e. Coarse hair

Anorexia; Cold intolerance; Coarse hair Explanation: Levothyroxine is used to treat hypothyroidism manifested by anorexia, coarse hair, cold intolerance, lethargy, and bradycardia (not tachycardia). Nervousness and tachycardia are possible adverse reactions to levothyroxine and would be evident on the ongoing assessment after therapy had started.

An older adult client living in a long-term care facility is newly diagnosed with hypothyroidism. The nurse is providing care and education to the client. What should be the nurse's priority action when managing hypothyroidism in the older adult? a. Recommend thyroidectomy as a curative treatment for the client's hypothyroidism. b. Initiate thyroid hormone replacement therapy at a standard dose to address the client's hypothyroidism. c. Assess the client for potential drug interactions and age-related changes affecting medication metabolism. d. Schedule the client for immediate radioactive iodine therapy to treat the hypothyroidism.

Assess the client for potential drug interactions and age-related changes affecting medication metabolism. Explanation: Assessing the client for potential drug interactions and age-related changes affecting medication metabolism is the most appropriate action. Older clients are more susceptible to drug interactions and may experience altered medication metabolism. It is crucial to evaluate the client's current medication regimen for potential interactions and to consider age-related changes when prescribing thyroid hormone replacement therapy. Initiating thyroid hormone replacement therapy at a standard dose without assessing for potential drug interactions and age-related changes in metabolism may lead to adverse effects or inadequate treatment and is, therefore, inappropriate. Scheduling the client for immediate radioactive iodine therapy is not indicated for hypothyroidism, as this treatment is typically reserved for hyperthyroid conditions. Recommending thyroidectomy as a curative treatment is not appropriate for hypothyroidism. Thyroidectomy is typically performed for hyperthyroidism or when there are thyroid nodules or malignancies, not for hypothyroidism.

A nurse is teaching a client about the thyroid hormone replacement therapy which has been prescribed. The nurse determines the teaching session is successful when the client indicates which time to take the drug? a. Before breakfast b. Just before dinner c. After lunch d. Before bedtime

Before breakfast Explanation: The nurse should inform the client undergoing thyroid hormone replacement therapy to take the drug in the morning before breakfast. These drugs should be taken on an empty stomach to ensure proper absorption.

A nurse is preparing to administer liothyronine to a client with chronic thyroiditis. The nurse determines the drug needs to be administered cautiously after noting which disorder in the client's medical history? a. Diabetes b. Elevated body temperature c. Cardiac disease d. Upper respiratory tract infection

Cardiac disease Explanation: The nurse should be cautious about existing conditions such as cardiac disease and also cautious about lactating clients before administering liothyronine to clients with chronic thyroiditis. The nurse need not be cautious about administering liothyronine to clients with an upper respiratory tract infection, diabetes, or elevated body temperature. The nurse should be cautious about clients contracting an upper respiratory tract infection on administrating antithyroid drugs. A client with diabetes may experience an increase in diabetes while undergoing thyroid hormone replacement therapy. The nurse should observe for elevated body temperature while managing the needs of a client administered thyroid hormones.

A client living with Hashimoto thyroiditis is receiving levothyroxine as part of their treatment plan. The nurse is reviewing the client's lab results, which show that the client's thyroid-stimulating hormone (TSH) level is within the normal range. The client reports feeling fatigued, experiencing muscle weakness, and gaining weight. Which nursing action is most appropriate in this situation? a. Collaborate with the health care provider to adjust the levothyroxine dosage. b. Advise the client to continue taking levothyroxine as prescribed. c. Recommend the client to increase physical activity to improve muscle strength. d. Educate the client on the importance of maintaining a low-calorie diet to manage weight gain.

Collaborate with the health care provider to adjust the levothyroxine dosage. Explanation: Hashimoto thyroiditis is an autoimmune disorder that results in hypothyroidism, leading to decreased production of thyroid hormones. Levothyroxine is a synthetic thyroid hormone replacement commonly used to manage hypothyroidism. When a client's TSH level is within the normal range, but they still experience symptoms of hypothyroidism, such as fatigue, weight gain, and muscle weakness, it suggests that the current levothyroxine dosage may be inadequate. The most appropriate action in this scenario would be to collaborate with the health care provider to possibly adjust the dosage of the medication. Educating the client on maintaining a low-calorie diet may be necessary if the weight gain is substantial, but it should not be the primary action when the underlying issue could be inadequate thyroid hormone replacement. Advising the client to continue taking levothyroxine as prescribed is insufficient when the client is experiencing persistent symptoms of hypothyroidism despite a normal TSH level. The dosage may need to be reevaluated. Recommending the client increase physical activity to improve muscle strength is generally a good health promotion strategy, but it is not the primary intervention when dealing with persistent hypothyroidism symptoms. Adjusting the medication regimen takes precedence in this scenario.

A health care provider has prescribed methimazole for an elderly client with hyperthyroidism who lives alone. Which potential nursing diagnosis should the nurse prioritize for this client? a. Disturbed thought processes related to adverse drug reactions b. Risk for impaired skin integrity related to adverse reactions c. Risk for ineffective health management d. Risk for infection related to adverse drug reactions

Risk for ineffective health management Explanation: The nurse should prioritize risk for ineffective health management for this client. The client with hyperthyroidism may be concerned with the results of medical treatment and with the problem of taking the drug at regular intervals around the clock. Risk for infection related to adverse drug reactions and risk for impaired skin integrity related to adverse reactions could also be appropriate for this client receiving antithyroid drugs; however, not the priority. Disturbed thought processes may apply for a client receiving ACTH.

The nurse is caring for a client who has a possible thyroid disorder and is aware that what medication will be used in diagnostic testing? a. Levothyroxine b. Sodium iodide^131 I c. Propranolol d. PTU

Sodium iodide^131 I Explanation: Sodium iodide^131 I is used in the diagnosis of thyroid disease and also in the treatment of hyperthyroidism.

A nurse is caring for a client with subacute lymphocytic thyroiditis. The health care provider prescribes thyroid hormones to the client. From which sign during ongoing assessment should the nurse conclude that the client is responding to the therapy? a. Flushing b. Excessive sweating c. Swollen neck d. Increased appetite

Increased appetite Explanation: The nurse should observe for signs of therapeutic responses, which include increased appetite, weight loss, mild diuresis, an increased pulse rate, and decreased puffiness of the face, hands, and feet. The nurse need not observe swollen neck, excessive sweating, or heat intolerance as signs of responding to therapy. Swollen neck, sore throat, and cough may occur after two to three days of administering radioactive iodine. Sweating and flushing are the adverse reactions to thyroid hormones.

A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find? a. Drowsiness and bradycardia b. Slow speech and mental dullness c. Nervousness and tachycardia d. Skin rash and itching

Nervousness and tachycardia Explanation: Excessive doses of levothyroxine, a thyroid drug, can cause the same signs and symptoms that occur with hyperthyroidism. These include nervousness and tachycardia.

A client is prescribed levothyroxine. The nurse understands that this drug contains: a. T3. b. T4. c. vitamin D. d. iodine.

T4. Explanation: Levothyroxine is a synthetic salt of T4; desiccated thyroid contains both T3 and T4. Liothyronine contains T3. Iodine is an antithyroid agent. Calcitriol is a form of vitamin D.

A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first? a. Record weight and report weight gain or loss. b. Notify the primary health care provider. c. Provide soothing cream to affected areas. d. Avoid using soap to cleanse affected areas.

Notify the primary health care provider. Explanation: Whenever a client develops a skin rash after taking propylthiouracil, the nurse must notify the primary health care provider immediately because it may be an adverse reaction. The other measures are important to protect the skin integrity: avoid soap and apply soothing cream to affected areas. Recording the weight and reporting weight gain or loss are also important.

The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition? a. Obesity b. GERD c. Diabetes mellitus type 1 d. Hypotension

Obesity Explanation: The FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of obesity or for weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop in euthyroid people taking thyroid hormones.

The nurse should teach clients who are taking thyroid hormones to take the medication: a. on an empty stomach b. at bedtime. c. in divided doses in the morning and evening. d. in the evening after dinner.

on an empty stomach. Explanation: Thyroid hormones are administered once per day, early in the morning and preferably before breakfast. An empty stomach increases the absorption of the drug.

The nurse is educating a client that is postmenopausal with subclinical hyperthyroidism. The client has been taking thyroid hormone therapy but not estrogen replacement therapy. What should the nurse be sure to include when discussing risk factors with this client? a. The increased risk of developing Alzheimer's disease due to increased thyroid hormone b. Reduction of bone mineral density leading to osteoporosis c. The increased risk of experiencing a thyroid storm d. Development of various types of tumor growth due to decreased secretion of thyroid hormone

Reduction of bone mineral density leading to osteoporosis Explanation: Subclinical hyperthyroidism is defined as a reduced TSH (less than 0.1 microunit/L) and normal T3 and T4 levels. The most common cause is excess thyroid hormone therapy. Subclinical hyperthyroidism is a risk factor for osteoporosis in postmenopausal women who do not take estrogen replacement therapy, because it leads to reduced bone mineral density. There is no correlation between subclinical hyperthyroidism and the development of cancerous tumors, Alzheimers Disease, or a thyroid storm.

A nurse is caring for a patient with hypothyroidism. The nurse would know that the effects of hypothyroidism include: a. Decreased cardiac output b. Nervousness and restlessness c. Increased blood pressure d. Fever

Decreased cardiac output Explanation: Decreased cardiac output is an effect of hypothyroidism. Low-grade fever, nervousness and restlessness, and increased systolic blood pressure are among the effects of hyperthyroidism.

A nurse is preparing to administer levothyroxine to a client who is also prescribed citalopram. The nurse predicts which assessment finding may occur in this client? a. Prolonged bleeding b. Increased risk of paresthesias c. Decreased effectiveness of the thyroid drug d. Increased risk of hypoglycemia

Decreased effectiveness of the thyroid drug Explanation: The nurse should monitor for a decreased effectiveness of the thyroid drug as the result of the interaction with selective serotonin reuptake inhibitors (SSRIs) such as citalopram. When the client is receiving oral anticoagulants with thyroid hormones, the client is at risk of prolonged bleeding. Increased risk of hypoglycemia occurs when oral hypoglycemics and insulin are administered with thyroid hormones to the client. The nurse should observe for paresthesias as one of the adverse reactions in a client receiving antithyroid drugs.

The nurse is caring for a client with severe hypothyroidism and knows to contact the health care provider if which symptoms of myxedema coma occur? (Select all that apply.) a. Decreased respirations b. Decreased blood pressure c. Decreased level of consciousness d. Fever e. High blood glucose level

Decreased respirations; Decreased blood pressure; Decreased level of consciousness Explanation: Symptoms of myxedema coma include coma, hypothermia, cardiovascular collapse, hypoventilation, hypoglycemia, and lactic acidosis.

A client presents to the emergency department with reports of lethargy, heavy menses, and an increase in weight of 10 pounds (4.5 kg) over the last month despite not having an appetite. The client's face appears puffy. The client has a history of diabetes, anxiety, high cholesterol, and attention-deficit hyperactivity disorder. The health care provider prescribes the client liothyronine and discharges the client. Which action should the nurse prioritize in this scenario? a. Instruct the client to schedule a follow-up appointment with their primary care provider for further evaluation. b. Provide the client with education about diet and exercise to help with weight management. c. Educate the client about the possible interaction between liothyronine and diabetic medications. d. Follow up with an endocrinologist to discuss the management of the client's thyroid disorder.

Educate the client about the possible interaction between liothyronine and diabetic medications. Explanation: The client's symptoms of lethargy, sleepiness, weight gain, puffy face, and heavy menses are suggestive of hypothyroidism. Liothyronine is a thyroid hormone drug used in the treatment of hypothyroidism and is known to interact with diabetic medications. The possible interaction between the two medications is an increased risk for hyperglycemia. Given the client's history of diabetes, the priority action in this scenario would be to educate the client regarding the possible interaction. While following up with an endocrinologist is essential for long-term management, the immediate priority is to educate the client on the possible interaction of their medications to ensure the client's safety. Scheduling a follow-up appointment with the client's primary health care provider is important for ongoing care and assessment but is not the priority in this scenario. Education on diet and exercise is also important for the client's overall health but would not be considered the priority in this scenario.

A client at a primary health care provider's office is diagnosed with multinodular goiter. The client has normal thyroid function and experiences no compressive symptoms. The health care provider prescribes levothyroxine. What is the nurse's priority action when educating the client about this treatment plan? a. Explain that levothyroxine will shrink the nodules and goiter quickly, providing immediate relief. b. Educate the client about the potential risks and benefits of levothyroxine treatment and the need for ongoing monitoring. c. Advise the client to discontinue any other medications and supplements to avoid interactions with levothyroxine. d. Recommend immediate surgery as the most effective and curative treatment for multinodular goiter.

Educate the client about the potential risks and benefits of levothyroxine treatment and the need for ongoing monitoring. Explanation: Educating the client about the potential risks and benefits of levothyroxine treatment and the need for ongoing monitoring is the priority action in this scenario. In cases of multinodular goiter with normal thyroid function and no compressive symptoms, levothyroxine is often prescribed to suppress thyroid-stimulating hormone levels, which may reduce the size of the goiter and nodules. Explaining that levothyroxine will provide quick relief is not accurate. The reduction in goiter size may take several months, and the client should have realistic expectations. Advising the client to discontinue other medications and supplements without assessing for potential interactions is not the priority. Medication interactions should be evaluated by the health care provider, and the client should not discontinue medications without medical guidance. Recommending immediate surgery is not appropriate for a client with multinodular goiter who has normal thyroid function and no compressive symptoms. Surgery is typically reserved for cases with compressive symptoms, significant discomfort, or nodules with concerning features.

A clinic nurse is taking care of a client who has come in for a prenatal checkup during their third trimester and appears to be emotionally upset. The client resides with their parent, who has recently been diagnosed with thyroid cancer and will be receiving radioactive iodine for treatment w/in the next week. What should be the nurses priority action in this scenario? a. Educate the about the risks of radioactive iodine exposure during pregnancy and recommend temporary separation from their parent during the treatment period b. Provide the client with information about the side effects and precautions related to their parents radioactive iodine therapy c. Refer the client for a psychological assessment to address any emotional stress related to their parent's diagnosis and treatment d. Schedule the client for a thyroid function test to assess their own thyroid status as thyroid cancer can have a genetic component

Educate the client about the risks of radioactive iodine exposure during pregnancy and recommend temporary separation from their parent during the treatment period. Explanation: Radioactive iodine exposure during pregnancy can have adverse effects on the developing fetus. The nurse should educate the client about the risks and recommend temporary separation from their parent during the radioactive iodine treatment to protect the fetus. While assessing the clients own thyroid function is important it is not the priority in this situation. The immediate concern is the potential radioactive iodine exposure to the pregnant client. Ensuring the client's safety and that of their developing fetus is the priority. While providing information about the side effects and precautions related to the client's parent's treatment plan is important, the primary concern is the potential radiation exposure to the pregnant client and the developing fetus. Addressing emotional stress is important, but it is not the priority in this scenario.

A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms? a. Sore throat b. Easy bruising c. Excessive fatigue d. Extreme tachycardia

Extreme tachycardia Explanation: Signs of thyrotoxicosis (increased hyperthyroidism) include high fever, extreme tachycardia, and altered mental status. A sore throat would alert the nurse to possible agranulocytosis. Fatigue is a sign of hypothyroidism. Bruising is a sign of increased bleeding tendency, not hyperthyroidism.

Which would a nurse expect to assess in a client experiencing hyperthyroidism? a. Intolerance to cold b. Flushed, warm skin c. Bradycardia d. Slow and deep tendon reflexes

Flushed, warm skin Explanation: Clients with hyperthyroidism typically exhibit flushed, warm skin; hyperactive deep tendon reflexes; tachycardia; and intolerance to heat.

A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed? a. Hyperthyroidism b. Chronic thyroiditis c. Hyperglycemia d. Hypothyroidism

Hyperthyroidism Explanation: Hyperthyroidism is manifested by increased appetite and metabolism. Without treatment, it may be difficult for hyperthyroid individuals to consume enough calories to prevent weight loss. Hypothyroidism, which may be caused by thyroiditis, causes decreased appetite and metabolism, and hypothyroid patients frequently experience weight gain.

What drug type is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders? a. calcium channel blockers b. thioamide antithyroids c. beta-adrenergic blockers d. opioid analgesics

opioid analgesics Explanation: Clients with hypothyroidism are especially likely to experience respiratory depression and myxedema coma with opioid analgesics and other sedating drugs. These drugs should be avoided when possible. None of the other options present with this contraindication.

A client diagnosed w/major depressive disorder is prescribed an antidepressant medication by their psychiatrist. The client has a history of hypothyroidism & takes levothyroxine. The nurse is providing education on the antidepressant medication. What is the priority action in managing this clients care? a. Advise the client to stop taking levothyroxine to avoid potential interactions with the new antidepressant & monitor thyroid function closely b. Schedule a follow-up w/the psychiatrist to discuss an alternative antidepressant that is less likely to interact with levothyroxine c. Start the client on a higher dose of levothyroxine to counteract any potential interaction w/the antidepressant & ensure adequate thyroid hormone levels d. Inform the client that taking an antidepressant may interfere w/the absorption and effectiveness of levothyroxine & recommend scheduling a follow-up appointment w/their endocrinologist

Inform the client that taking an antidepressant may interfere with the absorption and effectiveness of levothyroxine and recommend scheduling a follow-up appointment with their endocrinologist. Explanation: The interaction between antidepressant medications and levothyroxine is a critical consideration when managing a client with both MDD and hypothyroidism. Some antidepressants can interfere with the absorption of levothyroxine, potentially leading to inadequate thyroid hormone levels. The client should follow up with their endocrinologist for further guidance for their thyroid hormone replacement therapy. Advising the client to stop taking levothyroxine is not the appropriate action. Hypothyroidism requires thyroid hormone replacement therapy, and discontinuing levothyroxine can lead to serious health issues. Starting the client on a higher dose of levothyroxine without addressing the potential interaction with the antidepressant is not appropriate. This action is not within the nurse's legal scope of practice. Adjustments to thyroid hormone replacement therapy should be made under medical supervision based on thyroid function test results. Scheduling a follow-up appointment with the psychiatrist to discuss an alternative antidepressant is a valid option. However, the immediate priority is to ensure that the client understands the potential interaction with levothyroxine and following up with the appropriate provider for further guidance.

A client with hyperthyroidism began treatment with propylthiouracil two weeks ago and has presented for a follow-up assessment. The nurse's assessment findings include a heart rate of 58 beats/min with regular rhythm and blood pressure of 89/61 mm Hg. What is the nurse's most appropriate action? a. Document the expected reductions in heart rate and blood pressure in the client health record. b. Assess the client's risk for falls. c. Inform the health care provider. d. Teach the client how to self-monitor blood pressure and heart rate in the home.

Inform the health care provider. Explanation: While a reduction in blood pressure and heart rate is a desired effect of propylthiouracil these findings would likely be characterized as bradycardia and hypotension, and would warrant medical follow-up to reevaluate the drug regimen. Facilitating this follow-up is a priority nursing action, even though the data would certainly be documented. Similarly, it would be appropriate to assess the client's associated falls risk and reinforce self-monitoring, but neither of these actions directly addresses the need to have the regimen reevaluated by the care provider.

A client with hyperthyroidism, who is prescribed methimazole, reports a skin rash to the nurse. Which instruction should the nurse prioritize when assessing the client? a. Instruct the client to avoid applying lubricants. b. Instruct the client to use soap sparingly. c. Check if discoloration of the hair occurs. d. Offer suggestions to alter the drug schedule.

Instruct the client to use soap sparingly. Explanation: The nurse should instruct the client to use soap sparingly, if at all, and apply soothing creams or lubricants until the rash subsides. The dosing may need to be changed and the rash should be reported immediately to the health care provider. The nurse need not offer suggestions to alter the drug schedule, instruct the client to avoid applying lubricants, or check if discoloration of hair occurs.

A client is diagnosed with liver disease. How would this affect the metabolism of the drugs used to treat the client's hypothyroidism? a. It would be unaffected. b. It would be rapid. c. It would be prolonged. d. It would be short-lived.

It would be prolonged. Explanation: Drug metabolism in the liver is delayed in clients with hypothyroidism and liver disease, so most drugs given to these clients have a prolonged effect.

The nurse in the newborn nursery is assessing an infant with suspected congenital hypothyroidism. What assessment findings support this diagnosis? (Select all that apply.) a. Elevated temperature b. Lethargy c. Feeding difficulties d. Diarrhea e. Bradycardia

Lethargy; Feeding difficulties; Bradycardia Explanation: Symptoms that support a diagnosis of congenital hypothyroidism include subnormal temperature, low heart rate, feeding difficulties, lethargy, and constipation.

A health care provider has prescribed a medication for a client who is diagnosed with euthyroid goiter. The nurse would expect to administer which drug? a. Sodium iodide b. Propylthiouracil c. Methimazole d. Levothyroxine

Levothyroxine Explanation: Euthyroid goiter is treated with thyroid hormones, such as levothyroxine. Methimazole, propylthiouracil, and sodium iodide are used to treat hyperthyroidism.

The nurse cares for a client who was admitted for multiple bone fractures resulting from a fall. The client has a comorbidity of hypothyroidism. Which diet is the most appropriate for this client? a. High calorie, high fiber b. Low calorie, high fiber c. High calorie, low fiber d. Low calorie, low fiber

Low calorie, high fiber Explanation: Hypothyroidism slows the metabolism and decreases gastrointestinal secretions and motility. Hypothyroid clients, therefore, should be encouraged to eat a low-calorie, high-fiber diets to combat weight gain and constipation.

An adult client living with Graves' disease is admitted to the medical-surgical unit. The client has recently started a new medication and has been experiencing diarrhea. The nurse should prioritize which intervention in this scenario? a. Administer radioactive iodine therapy. b. Monitor for signs of thyroid storm. c. Teach the client about lifelong thyroid hormone replacement therapy. d. Initiate a low-iodine diet plan.

Monitor for signs of thyroid storm. Explanation: Graves' disease is an autoimmune disorder characterized by hyperthyroidism. The priority nursing intervention for this client is to monitor for signs of thyroid storm, which is a life-threatening complication of hyperthyroidism. Thyroid storm is characterized by severe tachycardia, high fever, diarrhea, vomiting, and altered mental status. Administering radioactive iodine therapy is a treatment option for Graves' disease but is not the priority nursing intervention. It is typically carried out by the health care provider or a nuclear medicine specialist. Teaching the client about lifelong thyroid hormone replacement therapy is important for clients who have undergone thyroidectomy or radioactive iodine therapy, but it is not the priority in this acute situation. Initiating a low-iodine diet plan is part of the preparation for radioactive iodine therapy but is not the priority at this time. Monitoring for thyroid storm takes precedence.

Which of the following drug types is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders? a. Inderal b. Opioid analgesics c. Calcium channel blockers d. Methimazole

Opioid analgesics Explanation: Clients with hypothyroidism are especially likely to experience respiratory depression and myxedema coma with opioid analgesics and other sedating drugs. These drugs should be avoided when possible.

A patient with hypothyroidism is at increased risk for respiratory depression and myxedema coma if given what category of drugs? a. Corticosteroids b. Nonsteroidal anti-inflammatory drugs c. Antibiotics d. Opioid analgesics

Opioid analgesics Explanation: Most drugs given to patients with hypothyroidism have a prolonged effect, because drug metabolism in the liver is delayed and the glomerular filtration rate of the kidneys is decreased. People with hypothyroidism are especially likely to experience respiratory depression and myxedema coma with opioid analgesics and other sedating drugs. These drugs should be avoided when possible.

Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs? a. Sodium iodide b. Propylthiouracil c. Levothyroxine d. Propranolol

Propylthiouracil Explanation: Propylthiouracil is the prototype of the thioamide antithyroid drugs. Although propranolol is used to treat some symptoms of hyperthyroidism, it is an antiadrenergic, not an antithyroid drug. Sodium iodide is a radioactive isotope that decreases thyroid hormone production by destroying thyroid tissue. Levothyroxine is a thyroid drug.

A client visits their primary health care provider with a request for a prescription of thyroid hormones to help them lose weight. The client is discussing with the nurse that they have heard about the weight loss benefits of thyroid hormones and wants to try them. What would be the best response by the nurse in this scenario? a. Advise the client to purchase over-the-counter thyroid supplements, which can be a safer option for weight loss. b. Offer to prescribe a low dose of thyroid hormones for a short-term weight loss trial, closely monitoring the client's progress. c. Explain that thyroid hormones are not effective for weight loss and suggest a healthy diet and exercise as safer alternatives. d. Provide information on the potential side effects of using thyroid hormones for weight loss and advise the client to consult the health care provider for a weight management plan.

Provide information on the potential side effects of using thyroid hormones for weight loss and advise the client to consult the health care provider for a weight management plan. Explanation: Using thyroid hormones for weight loss without a medical indication is not safe and can have serious consequences. When combined with other weight loss agents, clients can experience life-threatening effects. Providing information on these potential side effects and advising the client to consult the health care provider is the most appropriate response in this scenario. While suggesting to the client to start eating a healthy diet and exercising as safer alternatives to weight loss is valid, thyroid hormones actually can make a client lose weight; however, this method of weight loss is not recommended. Offering to prescribe thyroid hormones is outside of a nurse's legal scope of practice and is, therefore, incorrect. Advising the client to purchase over-the-counter thyroid supplements is not appropriate. Such supplements are unregulated and can be dangerous.

The nurse is discharging a client with newly prescribed thyroid hormone. Which health concern would be a contraindication to the client taking this medication? a. Recent myocardial infarction b. Adrenal cortical sufficiency c. Thinning hair d. Lactation

Recent myocardial infarction Explanation: Thyroid hormone should not be used after a recent myocardial infarction. When hypothyroidism is a cause or contributing factor to a myocardial infarction or heart disease, the health care provider may prescribe small doses of thyroid hormone. Thinning hair is a symptom of hypothyroidism and would likely be treated with the use of thyroid hormone, not a contraindication to it. Thyroid hormone is contraindicated in clients with an uncorrected adrenal cortical insufficiency not adrenal cortical sufficiency. Thyroid hormone is a category A drug, so it is safe for use in lactation.

A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug? a. tinnitus b. orthostatic hypotension c. persistent tachycardia d. visual disturbances

persistent tachycardia Explanation: Propylthiouracil (PTU) is used for the treatment of hyperthyroidism; one of the characteristic symptoms of this disease is tachycardia. Tinnitus, visual disturbances, and hypotension are not associated with hyperthyroidism.

During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response? a. While taking thyroid medication, the client needs to take additional dietary supplements of iodine as well. b. Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity. c. While taking thyroid medication, the client needs to take a calcium supplement as well. d. Taking thyroid medication will not contribute to weight loss but only result in a redistribution of fat deposits.

Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity. Explanation: The FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of obesity or weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop in euthyroid clients talking thyroid hormones.

The home care nurse may be involved in a wide range of activities when caring for the client with hyperthyroidism or hypothyroidism. What would be included in the client's plan of care? (Select all that apply.) a. Modifying medication dosages based on symptomatology b. Teaching about the disease process c. Provide information for rapid weight loss d. Preventing and managing adverse drug effects e. Assessing the client's response to therapy

Teaching about the disease process; Preventing and managing adverse drug effects; Assessing the client's response to therapy Explanation: The home care nurse may be involved in a wide range of activities, including assessing the client's response to therapy, teaching about the disease process, managing of symptoms, and preventing and managing adverse drug effects. The nurse would not modify medications without a provider's order or provide information about weight loss especially if the client has hyperthyroidism.

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine? a. The resident received her annual influenza vaccination the previous day. b. The resident has not eaten breakfast because of a recent loss of appetite. c. The resident had a fall during the night while transferring from her bed to her bathroom. d. The resident's apical heart rate is 112 beats/minute with a regular rhythm.

The resident's apical heart rate is 112 beats/minute with a regular rhythm. Explanation: If the pulse rate is greater than 100 bpm, it is necessary to withhold a levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent falls do not necessary indicate a need to withhold this medication.

Which hormone regulates the production and release of thyroid hormone? a. Tetraiodothyronine b. Triiodothyronine c. Thyrotropin-releasing hormone (TRH) d. Thyroid-stimulating hormone (TSH)

Thyroid-stimulating hormone (TSH) Explanation: The anterior pituitary hormone called thyroid-stimulating hormone (TSH) regulates thyroid hormone production and release. The secretion of TSH is regulated by thyrotropin-releasing hormone (TRH), a hypothalamic regulating factor. Tetraiodothyronine and triiodothyronine are thyroid hormones produced by the thyroid gland using iodine that is found in the diet.

Which hormone regulates the production and release of thyroid hormone? a. Triiodothyronine b. Thyroid-stimulating hormone (TSH) c. Tetraiodothyronine d. Thyrotropin-releasing hormone (TRH)

Thyroid-stimulating hormone (TSH) Explanation: The anterior pituitary hormone called thyroid-stimulating hormone (TSH) regulates thyroid hormone production and release. The secretion of TSH is regulated by thyrotropin-releasing hormone (TRH), a hypothalamic regulating factor. Tetraiodothyronine and triiodothyronine are thyroid hormones produced by the thyroid gland using iodine that is found in the diet.

A client has been diagnosed with subclinical hypothyroidism. The client reports feeling fine and does not want to take any medications. The nurse informs the client that some medical providers encourage pharmacological intervention to improve all of the following EXCEPT: a. Muscle function. b. Left ventricular function. c. Cholesterol metabolism. d. Weight loss.

Weight loss. Explanation: The FDA has issued a BLACK BOX WARNING regarding the use of thyroid hormones for the treatment of obesity or for weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop.

What is the most common cause of subclinical hyperthyroidism? a. excess thyroid hormone therapy b. central nervous system depressant therapy c. untreated osteoporosis d. history of neck radiation

excess thyroid hormone therapy Explanation: The most common cause of subclinical hyperthyroidism is excess thyroid hormone therapy. Clients should be monitored closely for hypothyroidism while taking antithyroid drugs, which usually develops within a year after receiving treatment for hyperthyroidism. Common causes of primary hypothyroidism include treatment of hyperthyroidism with radiation therapy or surgery. Predisposing factors for myxedema coma include administration of central nervous system depressants. Untreated osteoporosis is not relevant to subclinical hyperthyroidism.

The community health nurse is preparing to administer a prescribed dose of levothyroxine to a client. What is the nurse's priority assessment? a. level of consciousness b. respiratory rate and rhythm c. heart rate and rhythm d. blood glucose

heart rate and rhythm Explanation: The effects of hypothyroidism and thyroid medications are varied, due to the broad effects of thyroid hormones. However, cardiac function is among the most frequent and serious. For this reason, cardiac assessment is a priority. Hypothyroidism may cause drowsiness or decreased LOC, but this poses a lower risk to safety than cardiac issues. Blood glucose is less commonly affected and respiratory function is only affected as a consequence of cardiac dysfunction, as in cases of heart failure.

The nurse is providing care for an adult client who has been taking levothyroxine 150 mcg/d for the past several months to treat hypothyroidism. The nurse should include what assessment(s) related to the client's underlying diagnosis and medication regimen? Select all that apply. a. heart rate and rhythm b. lethargy c. signs and symptoms of depression or suicidal ideation d. blood pressure e. perceived heat and cold tolerance

heart rate and rhythm; lethargy; blood pressure; perceived heat and cold tolerance Explanation: The metabolic effects of hypothyroidism are varied, and treatment is expected to affect each of these. The nurse should expect to assess for regular heart rate that is within the reference range, absence of hypotension, and lethargy. Hypothyroidism is associated with cold intolerance, so the nurse should assess for an expected absence of that symptom. Hypothyroidism is characterized by low energy and drowsiness, but neither the diagnosis nor treatment with levothyroxine is associated with major depression or suicidal ideation.

A nurse is caring for a client undergoing thyroid hormone therapy for the treatment of multinodular goiter. The client informs the nurse that they are also taking an oral hypoglycemic drug. The nurse would be alert for which possible interaction? a. increased risk of hypoglycemia b. decreased effectiveness of the thyroid drug c. decreased number of white blood cells d. increased risk of prolonged bleeding

increased risk of hypoglycemia Explanation: The nurse should inform the client that there will be an increased risk of hypoglycemia as the effect of interaction between the thyroid hormone and hypoglycemics. The interaction between these two drugs does not decrease the effectiveness of the thyroid drug, decrease the number of white blood cells, or increase the risk of prolonged bleeding. Selective serotonin reuptake inhibitors (SSRIs) or antidepressants interact with thyroid hormones to cause decreased effectiveness of the thyroid drug. When methimazole is administered to the client, the nurse should monitor for a decrease in the number of white blood cells as an adverse reaction to the drug. When the client is administered thyroid hormones with oral anticoagulants, there will be an increased risk of prolonged bleeding.

The pharmacology instructor is providing education regarding propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication? a. Suppression of the anterior pituitary gland's hormonal secretions b. Sedation of the central nervous system and suppression of cardiac function c. Inhibition of production of thyroid hormone d. Destruction of part of the thyroid gland

inhibition of production of thyroid hormone Explanation: Propylthiouracil acts by inhibiting production of thyroid hormones and peripheral conversion of thyroxine (T4) to the more active triiodothyronine (T3).

With regard to the functioning of the thyroid gland, which is an essential element for the manufacturing of thyroxine and triiodothyronine? a. hydrogen b. potassium c. iodine d. sodium

iodine Explanation: Iodine is the essential element for the manufacturing of thyroxine and triiodothyronine. Sodium plays a key role in muscle contraction, nerve conduction, and water balance in the body. Hydrogen in the body is mostly found attached to oxygen to form water, and acts as a proton or positive ion in chemical reactions. Potassium is crucial to heart function and plays a key role in skeletal and smooth muscle contraction.

When describing thyroid function, the nurse would emphasize the need for intake of: a. sodium. b. calcium. c. vitamin B6. d. iodine.

iodine. Explanation: Iodine intake is necessary for the production of thyroid hormones.

The nurse is providing care for a client who has been admitted with clinical hypothyroidism. What interventions should the nurse implement to address common characteristics of the disorder? Select all that apply. a. maintain a warm room temperature b. implement falls risk precautions c. constant oxygen saturation monitoring d. provide a low-calorie diet e. monitor for constipation

maintain a warm room temperature; implement falls risk precautions; monitor for constipation Explanation: Clinical hypothyroidism produces variable signs and symptoms, depending on the amount of circulating thyroid hormone. Initially, manifestations are mild and vague. They usually increase in incidence and severity over time as the thyroid gland gradually atrophies. Clients with hypothyroidism are frequently cold intolerant; a warm environmental temperature is warranted. Signs and symptoms of hypothyroidism can also include weakness, tiredness, slow speech and body movements, emotional and mental dullness, excessive sleeping, constipation, and skin changes. There is no need for either continuous oxygen monitoring or a low-calorie diet.

A nurse is preparing to administer a scheduled dose of levothyroxine to an older adult client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment? a. measurement of blood pressure b. assessment of pupillary response c. chest auscultation for rales d. temperature measurement

measurement of blood pressure Explanation: In older adults receiving levothyroxine, regular monitoring of blood pressure and pulse is essential. Temperature, pupillary response, and chest auscultation are not necessary before safe administration of this medication.

Based on the nurse's knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder? a. cataract surgery b. hypoglycemic episode c. myocardial infarction d. seizure

myocardial infarction Explanation: A nurse should be cautious not to administer levothyroxine to a client who has recently had a myocardial infarction. Drug interactions with oral antidiabetics and insulin with hormone supplements can cause hyperglycemia. Seizure and cataract surgery are not contraindicated with the use of levothyroxine.

A client exhibits severe tachycardia, fever, dehydration, and heart failure. The nurse recognizes that these signs are consistent with what thyroid-associated health condition? a. myxedema b. subclinical hyperthyroidism c. Hashimoto's disease d. thyroid storm

thyroid storm Explanation: Thyroid storm is a crisis or life-threatening condition characterized by an exaggeration of the usual physiologic response seen in hyperthyroidism. Whereas hyperthyroidism can cause symptoms such as sweating, feeling hot, palpitations, and weight loss, the symptoms of thyroid storm are more severe, resulting in complications such as fever, rapid heart rate, nausea/vomiting, diarrhea, irregular heartbeat, weakness, heart failure, confusion/disorientation, and coma. Myxedema and Hashimoto's disease are forms of hypothyroidism, so they would not manifest similarly.