Patho Ch 41
The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin? PP cells Alpha cells Beta cells Delta cells
Beta cells Explanation: Each islet is composed of beta cells that secrete insulin and amylin, alpha cells that secrete glucagon, and delta cells that secrete somatostatin. In addition, at least one other type of cell, the PP cell, is present in small numbers in the islets and secrets a hormone of uncertain function called pancreatic polypeptide.
The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding? Respiratory rate 14 Blood pressure 180/110 mm Hg Heart rate 110 and bounding Temperature 96°F (35.5°C)
Heart rate 110 and bounding Explanation: Cardiovascular and respiratory functions are strongly affected by thyroid function. With an increase in metabolism, there is a rise in oxygen consumption and production of metabolic end products, with an accompanying increase in vasodilation. Blood volume, cardiac output, and ventilation are all increased. Heart rate and cardiac contractility are enhanced as a means of maintaining the needed cardiac output. Blood pressure is likely to change little because the increase in vasodilation tends to offset the increase in cardiac output.
A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided? Dextrose IV Glucose gel in the buccal pocket Orange juice orally IM glucagon injection
Orange juice orally Explanation: When clients are unconscious it is not safe to attempt to have them swallow liquids. Alternate routes that reduce the risk of choking such as buccal absorption, intramuscular or intravenous injections are preferred.
Select the most common symptoms of diabetes. Select all that apply. Polyuria Polycythemia Polyhydramnios Polyphagia Polydipsia
Polydipsia Polyuria Polyphagia Explanation: The most commonly identified signs and symptoms of diabetes are often referred to as the three polys: (1) polyuria (i.e., excessive urination), (2) polydipsia (i.e., excessive thirst), and (3) polyphagia (i.e., excessive hunger). Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac. Polycythemia is a condition of increased red blood cells.
The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers? Previous incidents of diabetic ketoacidosis Autonomic neuropathy Sensory neuropathy Microvascular disease
Sensory neuropathy Explanation: Sensory neuropathy is a major risk factor for foot ulcers due to the fact that people have impaired pain sensation and can be unaware of foot injuries and infections. Autonomic neuropathy, microvascular disease, or diabetic ketoacidosis, while not affecting risk for foot injuries, suggest that the client's diabetes is inadequately controlled.
A client with Graves disease has opthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse? "The protrusion of the eyes will get worse before they get better." "With treatment of the hyperthyroid state, the opthalmopathy usually tends to stabilize." "Once we treat your Graves disease, your eyes will go back to their normal state." "Your eyes will be like this but there are things we can do to reduce visual loss."
"With treatment of the hyperthyroid state, the opthalmopathy usually tends to stabilize." Explanation: The ophlalmopathy of Graves disease can cause severe eye problems, including tethering of the extraocular muscles resulting in diplopia; involvement of the optic nerve, with some visual loss; and corneal ulceration because the lids do not close over the protruding eyeball. The opthalmopathy usually tends to stabilize after treatment of the hyperthyroidism.
A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder? An older adult with a history of gestational diabetes A young child whose grandmother has type 2 diabetes A middle aged obese adult with a sedentary lifestyle An adult who has an active lifestyle and small waist-hip ratio
A middle aged obese adult with a sedentary lifestyle Explanation: The person most at risk for developing type 2 diabetes is the client with obesity and with a sedentary lifestyle. Other risk factors include family history, age older than 40, and history of gestational diabetes. The young child, despite family history, would be at low risk as long as obesity and sedentary lifestyle are avoided. The woman most likely would have developed type 2 diabetes within 20 years after the pregnancy.
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and: TSH DHEA GH ACTH
ACTH Explanation: One of the earliest signs of Cushing syndrome, a disorder of cortisol excess, is the loss of diurnal variation in CRH and adrenocorticotropin hormone (ACTH) secretion, with corticotropin-releasing hormone (CRH) controlling the release of ACTH. The adrenal sex hormone dehydroepiandrosterone (DHEA) contributes to the pubertal growth of body hair, particularly pubic and axillary hair in women. Thyroid-stimulating hormone (TSH) levels are used to differentiate between primary and secondary thyroid disorders. Although secretion of growth hormone (GH) has diurnal variations over a 24-hour period, with nocturnal sleep bursts occurring 1 to 4 hours after onset of sleep, it is unrelated to ACTH and/or CRH secretion.
The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism? Dehydration from diarrhea Accelerated growth Cretinism Irritability and restlessness
Cretinism Explanation: Congenital hypothyroidism is a common cause of preventable intellectual disability. It affects approximately 1 in 4000 infants. The manifestations of untreated congenital hypothyroidism are referred to as cretinism. The term does not apply to the normally developing infant in whom replacement thyroid hormones therapy was instituted shortly after birth.
Impaired and delayed healing in a person with diabetes is caused by long-term complications that include: Somogyi effect Chronic neuropathies Ketoacidosis Fluid imbalances
Chronic neuropathies Explanation: Suboptimal response to infection in a person with diabetes is caused by the presence of chronic complications, such as vascular disease and neuropathies, poorly controlled hyperglycemia, and altered immune cell and neutrophil function. Sensory deficits may cause a person with diabetes to ignore minor trauma and infection, and vascular disease may impair circulation and delivery of blood cells and other substances needed to produce an adequate inflammatory response and effect healing. Somogyi effect is an acute complication of diabetes, causing hypoglycemia. Ketoacidosis is an acute complication of hyperglycemia when liver ketone production exceeds cell use.
A client with type 2 diabetes experiences unexplained elevations of fasting blood glucose in the early morning hours. Which conditions can account for this effect? Autonomic neuropathy Diabetic ketoacidosis Inadequate bedtime insulin Dawn phenomenon
Dawn phenomenon Explanation: The dawn phenomenon involves increased levels of fasting blood glucose or insulin requirement during the early morning hours. It is not preceded by hypoglycemia. Circadian release of growth hormone and cortisol may be contributing factors. The other answer selections are not characterized by increased early morning levels of blood glucose.
A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options. Production of fatty acids and glycerol Low serum insulin levels Decrease in pH Ketone production by the liver Breakdown of triglycerides
Decrease in pH Breakdown of triglycerides Low serum insulin levels Ketone production by the liver Production of fatty acids and glycerol Explanation: During ketoacidotic episodes, the lack of insulin leads to mobilization of fatty acids from adipose tissue because of the unsuppressed adipose cell lipase activity that breaks down triglycerides into fatty acids and glycerol. The increase in fatty acid levels leads to ketone production by the liver and ultimately metabolic acidosis.
Diabetic ketoacidosis (DKA) in a client with type 1 diabetes occurs when the lack of insulin leads to the release of which physiologic product? Bicarbonate Cortisol Potassium Fatty acids
Fatty acids Explanation: DKA most commonly occurs in type 1 diabetes, when the lack of insulin leads to unsuppressed adipose cell lipase activity that breaks down triglycerides into fatty acids and glycerol. The subsequent increase in fatty acid levels leads to ketone production by the liver. Serum potassium levels may be normal or elevated, despite total potassium depletion resulting from protracted polyuria and vomiting. Metabolic acidosis is caused by the excess ketoacids that require buffering by bicarbonate ions; this leads to a marked decrease in serum bicarbonate levels. Stress increases the release of cortisol and other gluconeogenic hormones and predisposes the person to the development of ketoacidosis.
The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan? Potassium supplements Insulin Ketoconazole Hydrocortisone
Hydrocortisone Explanation: The daily regulation of the chronic phase of Addison disease is usually accomplished by oral replacement therapy, with higher doses being given during periods of stress. Hydrocortisone is usually the drug of choice in treating Addison disease. In mild cases, hydrocortisone alone may be adequate. Ketoconazole causes excessive breakdown of glucocorticoids and can also result in adrenal insufficiency. Clients with Addison disease usually have elevated potassium levels, and insulin is not a treatment for Addison disease.
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes. Rotate insulin injection sites once a week Inspect the feet for blisters daily Wear comfortable, open-toed shoes Decrease daily walking activity
Inspect the feet for blisters daily Explanation: A client with neuropathy is at risk for damage to his or her feet, such as blisters or ulcers, as the clients are unable to feel this damage. Clients need to inspect their feet daily, wear foot coverings (such as closed-toe shoes) to prevent injuries, and continue the exercise patterns to promote improved circulation.
The diagnosis of type 1 diabetes would be confirmed by which principle? Insulin is not available for use by the body. Insulin is produced but unavailable for use in the body. Insulin is present in large amounts for use by the body. Small amounts of insulin are produced daily.
Insulin is not available for use by the body. Explanation: Type 1 diabetes is a catabolic disorder characterized by an absolute lack of insulin. In type 2 diabetes, some insulin is produced.
A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information? Visit your eye health professional for annual exams. Wear glasses when reading and limit computer time. Maintain healthy blood pressure and blood sugar levels. Control stress and monitor vision changes.
Maintain healthy blood pressure and blood sugar levels. Explanation: Diabetic retinopathy occurs when blood vessels have increased permeability, develop microaneurysms, vascular proliferation, scarring, and retinal detachment. These conditions are worsened when the client has poor glycemic control, poorly controlled hypertension, and hyperlipidemia. Laser photocoagulation can be used to stop vessel proliferation and bleeding. An annual examination will evaluate the disease, but does not prevent recurrence. Eye use patterns do not change retinopathy.
The newborn nursery nurse is preparing to perform a required neonatal screening for congenital hypothyroidism. What should the nurse do to obtain the necessary sample? Perform a heel stick to obtain a drop of blood for a T4 and TSH. Obtain a serum blood sample for T3 and T4. Place a urinary bag over the genitals to collect a urine specimen for T3 and TSH. Obtain a blood sample from a scalp vein.
Perform a heel stick to obtain a drop of blood for a T4 and TSH. Explanation: Screening is usually done in the hospital nursery. In this test, a drop of blood is taken from the infant's heel and analyzed for T4 and TSH.
A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome? Glycosylated hemoglobin 7.2% (.07) Gained 5 lb in one week 1% ketones present in urine Random blood glucose 85 mg/dL (4.72 mmol/L)
Random blood glucose 85 mg/dL (4.72 mmol/L) Explanation: The goals of the nutritional plan for gestational diabetes mellitus (GDM) include normal glucose levels, no ketosis, proper weight gain for the pregnancy, and adequate nutrition for fetal health.
The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications? The client should be informed that if he observes an increase in fatigue, an extra dose of his thyroid medication should be taken. The client should not participate in any exercise activity that could utilize more thyroid hormone. The client should skip a dose of the thyroid supplement if he has symptoms of fever or restlessness. The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.
The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention. Explanation: Prevention is preferable to treatment and entails special attention to high-risk populations, such as women with a history of Hashimoto thyroiditis. These persons should be informed about the signs and symptoms of severe hypothyroidism and the need for early medical treatment.
An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics? Weight loss, glucose monitoring, and oral antihyperglycemic medications Continuous subcutaneous insulin infusion (CSII) and nutrition management Injectable insulin, nutrition management, and adequate hydration Daily monitoring for urine ketones and weight loss measures.
Weight loss, glucose monitoring, and oral antihyperglycemic medications Explanation: Persons with type 2 diabetes would be unlikely to require insulin initially and oral medications are likely to be of benefit as an addition to weight loss and glucose monitoring.
When educating a client about glargine, the nurse should explain that this medication: has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours. will have a peak effect within 30 minutes, and thus it can be taken after a meal. is a combination with short acting and intermediate acting insulin so it is safe to take anytime throughout the day. has a rapid onset and peaks in about 5 minutes after injection, so the client will need to eat food immediately after injection.
has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours. Explanation: Glargine is long-acting insulin that has a slow, prolonged absorption rate and provides a relatively constant concentration over 12-24 hours. Rapid acting insulin has a rapid onset and peaks in about 5 minutes after injection. Short acting insulin will have a peak effect within 30 minutes, and thus it can be taken after a meal. Intermediate-acting insulin is a combination with short acting insulin so it is safe to take anytime throughout the day.
Which pathophysiologic phenomeon may result in a diagnosis of Cushing disease? Malfunction of the HPA system Hypopituitarism Excess ACTH production by a pituitary tumor Autoimmune destruction of the adrenal cortex
Excess ACTH production by a pituitary tumor Explanation: Three important forms of Cushing syndrome result from excess glucocorticoid production by the body. One is a pituitary form, which results from excessive production of ACTH by a tumor of the pituitary gland. Hypopituitarism and destruction of the adrenal cortex are associated with Addison disease. Disruption of the HPA system is not implicated in the etiology of Cushing disease.
A client is seeking treatment for infertility. What decrease in hormone secretion from the anterior lobe of the pituitary gland that regulates fertility would the nurse recognize may cause this issue? Luteinizing hormone (LH) Thyroid-stimulating hormone (TSH) Follicle stimulating hormone (FSH) Adrenocorticotropic hormone (ACTH)
Follicle stimulating hormone (FSH) Explanation: ACTH controls the release of cortisol from the adrenal gland. TSH controls the secretion of thyroid hormone from the thyroid gland. LH regulates sex hormones. FSH regulates fertility.
The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is: "Your child is not old enough to swallow the pills needed to treat her diabetes." "When your child gets old enough, you will not have to administer injections." "Insulin is destroyed by the stomach contents and has to be administered by injection." "Insulin needs to go directly into the vein to work best."
"Insulin is destroyed by the stomach contents and has to be administered by injection." Explanation: Insulin is destroyed by the gastrointestinal tract and needs to be administered via injection or inhalation. Type 1 diabetes is not treated with oral medications at this time. Insulin is administered subcutaneously rather than in the vein. The statement about the mother not having to give injections once the child is older does not address the mother's concerns.
The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that addidtional teaching is needed? "If I work on losing some weight, that might help prevent complications later." "An exercise plan will be helpful for prevention of long-term complications." "If I forget my insulin in the morning, I should take it as soon as I can to prevent hyperglycemia." "So I can stop my insulin if I start an exercise program."
"So I can stop my insulin if I start an exercise program." Explanation: Clients with type 1 diabetes require insulin therapy from the time of diagnosis. Weight loss and dietary management may be sufficient to control blood glucose levels. Treatments which involve medical nutrition therapy, exercise, and insulin will help prevent complications later on as the client ages.
Which complication of acromegaly can be life threatening? Bone overgrowth causes arthralgias Vertebral changes result in kyphosis Splayed teeth result in impaired chewing Cardiac structures increase in size
Cardiac structures increase in size Explanation: While all the complications can exist, it is the enlargement of the heart and accelerated atherosclerosis that may lead to an early death. The teeth become splayed, causing a disturbed bite and difficulty in chewing. Vertebral changes often lead to kyphosis, or hunchback. Bone overgrowth often leads to arthralgias and degenerative arthritis of the spine, hips, and knees. Virtually every organ of the body is increased in size.
A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action? Teaching the client about the action and safe administration of insulin. Assisting the client with the appropriate choice of oral antihyperglycemics. Helping the client make meaningful changes to his diet and activity level. Educating the client about the risks and management of hypoglycemia.
Helping the client make meaningful changes to his diet and activity level. Explanation: Weight loss and dietary management are the initial focus of treatment for type 2 diabetes. For many people with type 2 diabetes, the benefits of exercise include a decrease in body fat, better weight control, and improvement in insulin sensitivity. If good glycemic control cannot be achieved with exercise and diet, then antidiabetic agents and even insulin can be added to the treatment plan. Education is imperative, but there is no need to emphasize hypoglycemia, since the client will not be using insulin initially.
The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is: "Your child is not old enough to swallow the pills needed to treat her diabetes." "Insulin needs to go directly into the vein to work best." "Insulin is destroyed by the stomach contents and has to be administered by injection." "When your child gets old enough, you will not have to administer injections."
"Insulin is destroyed by the stomach contents and has to be administered by injection." Explanation: Insulin is destroyed by the gastrointestinal tract and needs to be administered via injection or inhalation. Type 1 diabetes is not treated with oral medications at this time. Insulin is administered subcutaneously rather than in the vein. The statement about the mother not having to give injections once the child is older does not address the mother's concerns.
After receiving change-of-shift report about the following four clients, which client should the nurse assess first? 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.2°F (39.6°C) 22-year-old admitted with SIADH who has a serum sodium level of 130 mEq/L (130 mmol/L) 31-year-old who has iatrogenic Cushing syndrome with a capillary blood glucose level of 204 mg/dL (11.32 mmol/L) 53-year-old who has Addison disease and is due for a scheduled dose of hydrocortisone
70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.2°F (39.6°C) Explanation: Manipulation of a hyperactive thyroid gland during thyroidectomy can cause thyroid storm. It is manifested by very high fever, extreme cardiovascular effects (tachycardia, HF, angina), and severe CNS effects (agitation, restlessness, and delirium). The 22-year-old has normal sodium levels. The 31-year old has a high blood glucose level but not at a critical level. The medication schedule for the 53-year-old is lower priority. It is always preferred to give medications in timely manner; however, thyroid storms are the priority for this group of clients.
The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis? T-lymphocyte-mediated hypersensitivity reactions Destruction of beta cells that is not attributable to autoimmunity Actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs) Beta cell exhaustion due to long-standing insulin resistance
Beta cell exhaustion due to long-standing insulin resistance Explanation: Exhaustion of the beta cells arising from insulin resistance is characteristic of type 2 diabetes. Beta cell destruction in the absence of an autoimmune reaction is associated with type 1b diabetes, while autoimmune processes contribute to type 1a diabetes.
The nurse is caring for a client with secondary adrenal insufficiency. What subjective assessment data obtained by the nurse would correlate with this client's condition? Client states, "I feel as though I am going to vomit." Client states, "I don't feel like eating anything." The client states that she feels weak. The client has a blood pressure reading of 90/60 mm Hg. The client has a fever of 101°F (38.3°C).
Client states, "I don't feel like eating anything." Client states, "I feel as though I am going to vomit." The client states that she feels weak. Explanation: ACTH deficiency (secondary adrenal insufficiency) is the most serious endocrine deficiency, leading to weakness, nausea, anorexia, fever, and postural hypotension. Fever and hypotension are objective assessment data.
A client with Graves disease has had radioiodine treatment with worsening of ophthalmopathy. What medication does the nurse prepare to administer that the client will use for several weeks to decrease these symptoms? Diphenhydramine Levothyroxine Glucocorticoids Beta-adrenergic blockers (beta-blockers)
Glucocorticoids Explanation: Some physicians prescribe glucocorticoids for several weeks surrounding the radioiodine treatment if the person had signs of ophthalhmopathy.
A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis? Hypernatremia Hyponatremia Hypoglycemia Hyperglycemia
Hypoglycemia Explanation: Alcohol decreases liver gluconeogenesis, and people with diabetes need to be cautioned about its potential for causing hypoglycemia, especially if alcohol is consumed in large amounts or on an empty stomach.
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing? Elevated WBC count Increase in sedimentation rate Positive C-reactive protein Increased levels of ACTH
Increased levels of ACTH Explanation: Hyperpigmentation results from elevated levels of ACTH. The skin looks bronzed or suntanned in exposed and unexposed areas, and the normal creases and pressure points tend to become especially dark. The gums and oral mucous membranes may become bluish-black. The amino acid sequence of ACTH is strikingly similar to that of melanocyte stimulating hormone; hyperpigmentation occurs in more than 90 percent of persons with Addison disease and is helpful in distinguishing the primary and secondary forms of adrenal insufficiency.
The nurse is caring for a client with cirrhosis of the liver. Which medications prescribed by the physician should the nurse question since they may affect the binding of thyroid hormone to normal concentrations of binding proteins? Select all that apply. Diazepam Lisinopril Aspirin Metoprolol Phenytoin
Phenytoin Aspirin Diazepam Explanation: Medications such as phenytoin, salicylates, and diazepam can affect the binding of thyroid hormone to normal concentrations of binding proteins.
A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client. The client is at risk for an insulin reaction. The client is at risk for developing hyperglycemia. The client needs to modify the diet related to the low readings. The client is achieving normal glycemic control.
The client is achieving normal glycemic control. Explanation: The reading for the fasting blood glucose is appropriate, and the hemoglobin A1C level estimates good control of glucose levels over a 6- to 12-week period. This client should continue the exercise and diet routine as planned.
The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation? The client should be informed that if he begins to feel symptoms getting worse, he should take an extra dose of medication. The client should be strongly urged not to smoke. The client should be strongly encouraged not to drink any alcohol. The client should be informed that he should not be in contact with other people during the acute phase.
The client should be strongly urged not to smoke. Explanation: Ophthalmopathy can also be aggravated by smoking, which should be strongly discouraged. It is not necessary for the client to avoid contact with others. Alcohol is not contraindicated but should be limited when taking any medication regimen. The client should not adjust the doses of medications without first consulting the physician.
A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant taking thyroid hormone supplement, what should be included in the education? The infant will have to take the medication only until he reaches puberty. The infant will have dosage levels adjusted as he grows. Once the dosage levels are adjusted, the infant will remain on the same amount throughout life. The medication dosage will increase every 6 months after laboratory testing.
The infant will have dosage levels adjusted as he grows. Explanation: Congenital hypothyroidism is treated by hormone replacement. Evidence indicates that it is important to normalize T4 levels as rapidly as possible because a delay is accompanied by poorer psychomotor and mental development. Dosage levels are adjusted as the child grows. When early and adequate treatment regimens are followed, the risk of intellectual disability in infants detected by screening programs is essentially nonexistent.
A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication? Addisonian crisis Hypothyroidism Myxedema coma Thyroid storm
Thyroid storm Explanation: The symptoms this client is experiencing are related to thyroid storm and must be treated immediately to prevent death. Myxedema coma is related to hypothyroidism but typically does not occur after a thyroidectomy. Addisonian crisis is related to hypoadrenalism.