Pharmacology II Prep U Chapter 37: Thyroid and Parathyroid Agents
What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism?
"Do you have any trouble swallowing?"
A client is prescribed calcitriol. Which instruction would be most important for the nurse to include in the teaching plan?
"Have your calcium levels checked periodically."
The nurse is teaching a patient who is prescribed calcitriol about the drug. Which patient statement indicates that the teaching was successful?
"I need to have my calcium levels checked periodically."
An older adult client has been using levothyroxine for several years on an outclient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine?
"I've been using a lot of antacids lately because of my indigestion."
A female client with hyperthyroidism reports nervousness and "racing" heart one week after starting antithyroid medication. How should the nurse respond to the client's report?
"It may take three to four weeks for the effects of this medication to be seen."
While reviewing the medication history of a client receiving alendronate, the nurse notes that the client also takes a multivitamin. Which instruction would be most appropriate?
"Separate taking the two drugs by about a half hour."
The nurse is providing client teaching regarding the administration of levothyroxine (Synthroid). What is the nurse's priority teaching point?
"Take the medication with a full glass of water."
A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response?
"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy."
A nurse is providing education to a client who will soon begin taking levothyroxine for the first time. Which teaching point should the nurse include in this education session?
"You'll most likely take this drug for the rest of your life."
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.)
* Assessing the client's response to therapy * Teaching about the disease process * Preventing and managing adverse drug effects
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.)
* Decreased level of consciousness * Decreased respirations * Decreased blood pressure
Thyroid hormones are principally concerned with the increase in metabolic rate of tissues that can result in certain effects? What are some of these effects? (Select all that apply.)
* Increased heart rate * Increased body temperature * Increased cardiac output
Which hormones are secreted by the thyroid gland? (Select all that apply.)
* Thyroxine * Triiodothyronine
The nurse should assess for an enlarged thyroid by palpating which area?
Anterior neck
A client prescribed levothyroxine asks the nurse to explain when the medication should be taken. Which would the nurse include in the response?
In the morning on an empty stomach
The nurse should expect which assessment findings in a client diagnosed with Hashimoto's thyroiditis?
Blood pressure 110/70
The nurse knows that which assessment finding suggests hyperthyroidism?
Blood pressure 145/87
The home care nurse is caring for an elderly female patient who has been diagnosed with osteoporosis. When explaining the disease and its treatment to the patient, what should the nurse identify as a potentially serious complication?
Bone fracture
A patient has hypocalcemia secondary to hypoparathyroidism. Which would the nurse expect to be ordered?
Calcitrol
The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?
Calcium
A health care provider has recommended that a client undergo thyroid diagnostic testing. During the course of therapy, the client experiences myxedema due to the administration of an inadequate dose. Which symptom should the nurse monitor for in the client?
Cold intolerance
All of the following are specific physiological effects of thyroid hormones, EXCEPT:
Increased pituitary secretion of TSH.
A nurse is caring for a patient with hypothyroidism. The nurse would know that the effects of hypothyroidism include:
Decreased cardiac output
More patients experience hyperthyroidism than hypothyroidism.
False
Which would a nurse expect to assess in a client experiencing hyperthyroidism?
Flushed, warm skin
The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication?
Heart rate of 110 beats per minute
What is the best position for the client after the administration of a bisphosphonate medication?
High Fowler's
A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed?
Hyperthyroidism
What is the most common cause of subclinical hyperthyroidism?
excess thyroid hormone therapy
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?
Inhibition of production of thyroid hormone
Which agent would a nurse expect to administer to a client with hypothyroidism?
Levothyroxine
An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription?
Levothyroxine (Synthroid) 150 mcg orally once per day
A client with a history of cardiovascular disease, who is taking a thyroid hormone, reports chest pain. What is the nurse's best action?
Notify the health care provider.
A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first?
Notify the primary health care provider.
A nurse is reviewing the laboratory values of a client being treated for a diagnosis of hypocalcemia. The current serum calcium level is 8.1 mg/dL. What intervention does the nurse expect the prescriber to order?
Order an additional calcium supplement.
The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect?
Osteoporosis
A client is prescribed levothyroxine. The nurse understands that this drug contains:
T4
A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?
Tachycardia
A nurse is caring for a patient with thyrotoxicosis. The physician prescribes liotrix to the patient. Which adverse reaction to the drug should the nurse monitor for in the patient?
Tachycardia
The nurse should monitor a client for which effect of a drug interaction in a client taking thyroid hormones and a beta blocker?
Tachycardia
A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug?
Take the drug before breakfast.
Calcitonin balances the effects of parathyroid hormone.
True
Graves' disease is the most common cause of hyperthyroidism.
True
Thyroid hormones can be measured as protein-bound iodine.
True
The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client?
Vital signs
Which vitamin supplements should the nurse recommend while a postmenopausal client is taking alendronate (Fosamax)?
Vitamin D and calcium
What statement should be the basis for a nurse's description of the role of the parathyroid on the development of osteoporosis?
When there is too much parathyroid hormone, the bones release their calcium into the blood at a rate that is too high, resulting in bones which have too little calcium.
What is the rationale for a nurse to suggest avoiding whole grains to a client being treated for osteopenia?
Whole grains are known to interfere with calcium absorption.
While the nurse is talking with a client, the client informs the nurse that the client has been under treatment for weight loss management. The client indicates taking antithyroid medication to increase weight loss. Included in client education about antithyroid medication is that taking:
excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity.
A nurse is caring for a client with chronic lymphocytic thyroiditis. The health care provider has prescribed liothyronine. For which condition of the client should the nurse be cautious before administering the drug?
cardiac disease
A client's low ionized calcium levels have necessitated an infusion of an IV calcium preparation. During the administration of this medication, the nurse should prioritize what assessment?
cardiac monitoring
A client has been diagnosed with hypothyroidism and admits to the nurse that she has heard of her thyroid gland but does not know the function of thyroid hormone. The nurse should explain the fact that thyroid hormone is responsible for which action?
controlling the rate of cell metabolism throughout the body
A client is receiving propylthiouracil. The nurse anticipates a reduction in the client's dosage based on assessment of:
decreased appetite
What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine?
heart rate
A middle-aged client is proactive with personal health maintenance and reports taking 2400 International Units of vitamin D daily, stating, "More is better when it comes to vitamins." The nurse should provide health teaching to the client associated with a risk for which disorder?
hypercalcemia
With regard to the functioning of the thyroid gland, which is an essential element for the manufacturing of thyroxine and triiodothyronine?
iodine
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine.
A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment?
measurement of blood pressure
The nurse should advise a client who is taking levothyroxine for the first time that resolution of hypothyroid symptoms may not occur for how long after therapy is started?
weeks
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?
myocardial infarction
A client diagnosed with excessive parathyroid production is prone to develop:
osteopenia
What organ provides the control over the amount of calcium in the blood?
parathyroid glands
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?
persistent tachycardia
Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up?
routine liver function testing
