Thyroid ATI Medication
A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions? Excessive bleeding Ecchymosis Infection !!! Hyperglycemia
Excessive bleeding is a risk with many disorders and various medication therapies, such as anticoagulation therapy, but not with agranulocytosis. Ecchymosis is a risk with many disorders and various medication therapies, such as anticoagulation therapy, but not with agranulocytosis. !!! Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection. Hyperglycemia is a risk with many disorders and various medication therapies, such as glucocorticoid therapy, but not with agranulocytosis.
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? Insomnia !!! Constipation Drowsiness Hypoactive deep-tendon reflexes
!!! Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia. Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine.
A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the. following laboratory values? Thyroid stimulating hormone (TSH) !!! Free T4 Serum T4 Serum T3
!!! The nurse should anticipate that TSH will be elevated. The nurse should anticipate that the client's level of free T4 will be decreased. The nurse should anticipate that the client's serum T4 will be decreased. The nurse should anticipate that the client's level serum T3 will be decreased.
A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? Decrease in level of thyroxine (T4) Increase in weight Increase in hr of sleep per night Decrease in level of thyroid stimulating hormone (TSH). !!!
If the dose of this medication has been adequate, the nurse should see an increase in the T4. If the dose of this medication has been adequate, the nurse should see a decrease in weight, as hypothyroidism causes a decrease in metabolism with weight gain. If the dose of this medication has been adequate, the nurse should see a decrease in the hr of sleep per night, as hypothyroidism causes sluggishness with increased hr of sleep. !!! In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a decreased level of TSH.
A nurse is assessing a client who is receiving liothyronine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication? Decrease in appetite Increase in weight Increase in energy !!! Decrease in body temperature
Improved appetite is a therapeutic effect of liothyronine. A decrease in appetite is a manifestation of hypothyroidism. An increase in weight is a manifestation of hypothyroidism. One therapeutic effect of liothyronine is a reduction of this manifestation. !!! An increase in energy is a therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations. An increase in temperature is a manifestation of hypothyroidism. Body temperature should return to the expected reference range with effective therapy.
A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? Radioactive iodine Levothyroxine !!! Sumatriptan Levofloxacin
Radioactive iodine is an anti-thyroid medication that is used to treat thyroid cancer, hyperthyroidism and as a diagnostic aid for thyroid function studies. It is not used in the treatment of hypothyroidism. !!! Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on the use of this medication. Sumatriptan is an anti-migraine agent used for acute treatment migraine and cluster headaches. It is not used in the treatment of hypothyroidism. Levofloxacin is a broad spectrum anti-infective of the quinolone class that is used to treat infections of the sinuses, skin, lungs, ears, airways, bones, joints, and urinary tract. It is not used in the treatment of hypothyroidism.
A nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements? Saw palmetto Cranberry Soy !!! Garlic
Saw palmetto can increase the risk for bleeding in clients who take anticoagulants or antiplatelet medications. Cranberry juice can increase the risk for uric acid kidney stones and can also increase the risk of bleeding in clients who take warfarin. !!! The nurse should instruct the client to avoid soy because soy can reduce the effectiveness of the levothyroxine. Garlic can increase the risk for bleeding in clients who take anticoagulants or antiplatelet medications.
A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Drowsiness Bradycardia Dry skin Heat intolerance !!!
The client who has an acute overdose of levothyroxine will exhibit insomnia, not drowsiness. The client who has an acute overdose of levothyroxine will exhibit tachycardia, not bradycardia. The client who has an acute overdose of levothyroxine will exhibit sweating and hyperthermia, not dry skin. !!! The client who has an acute overdose of levothyroxine will exhibit heat intolerance, sweating, and hyperthermia. These manifestations are indications of excessive levels of thyroid hormone that could lead to death.
A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client? "Take this medication until your symptoms are gone and then discontinue." "Tremors, nervousness, and insomnia may indicate your dose is too high."!!! "Symptoms improve immediately after starting the medication." "The medication decreases the overproduction of the thyroid hormone thyroxine."
The nurse should teach that the medication replacement therapy is lifelong not discontinued. !!! The nurse should teach that tremors, nervousness, and insomnia may indicate an overdose of the medication and to notify the provider. The nurse should teach that It may take up to 6 weeks for the medication to reach the full effect. The nurse should teach that the medication is a synthetic thyroid hormone replacement and is not used to decrease overproduction the thyroxine.
