Chapter 50-2

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake."

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.

-Hypothermia -Hypotension -Hypoventilation

A nurse is providing care to a client with primary hyperparathyroidism. Which interventions would be included in the client's care plan? Select all that apply.

-Monitor gait, balance, and fatigue level with ambulation. -Monitor for fluid overload.

A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and:

vitamin D.

Which intervention is the most critical for a client with myxedema coma?

Maintaining a patent airway

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?

Calcium gluconate

A client has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this client's immediate care? Select all that apply

-Administering beta blockers to reduce heart rate -Applying interventions to reduce the client's temperature -Administering corticosteroids

The nurse is caring for a patient with hyperparathyroidism and observes a calcium level of 16.2 mg/dL. What interventions does the nurse prepare to provide to reduce the calcium level? Select all that apply.

-Administration of calcitonin -Intravenous isotonic saline solution in large quantities -Monitoring the patient for fluid overload

A client has a 20-year history of hypothyroidism and has not been compliant with taking thyroid replacement therapy. The client is brought into the ED and is given a diagnosis of myxedema coma. What signs and symptoms are consistent with this life-threatening event?

All Options are correct Explanation: Signs of this life-threatening event are hypothermia, hypotension, and hypoventilation

When thyroid hormone is administered for prolonged hypothyroidism for a patient, what should the nurse monitor for?

Angina

The most common cause of hypothyroidism is which of the following?

Autoimmune thyroiditis

Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy.

Calcium

A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit?

Calcium gluconate

A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test?

Fine-needle biopsy of the thyroid gland

Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism?

Hand flexing inward

Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor?

Handle body fluids carefully.

An older adult female client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse should suspect which disorder?

Hyperparathyroidism

On the third day after a partial thyoidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reposrts numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediatley. Which electrolyte disturbance most commonly follows thyroid surgery?

Hypocalcemia

When reviewing laboratory results for a patient with a possible diagnosis of hypoparathyroidism, the nurse knows that this condition is characterized by which of the following?

Inadequate secretion of parathormone

The most common type of goiter is caused by lack of which of the following?

Iodine

The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?

Iodine

One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is:

Kidney stones.

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?

Levothyroxine sodium

The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid?

Milk

A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?

Myxedema coma

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?

Myxedema coma

A client is undergoing a diagnostic workup for suspected thyroid cancer. What is the most common form of thyroid cancer in adults?

Papillary carcinoma

On assessment of a patient with early-stage hypothyroidism, the nurse practitioner assesses for a vague yet significant sign which is:

Paresthesia

The nurse is caring for a client with hypoparathyroidism. When the nurse taps the client's facial nerve, the client's mouth twitches and the jaw tightens. What is this response documented as related to the low calcium levels?

Positive Chvostek's sign

A client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add?

Related to bone demineralization resulting in pathologic fractures

A nurse is caring for a client with suspected hyperparathyroidism. Which condition may contribute to hyperparathyroidism?

Renal failure

A client has been admitted to the postsurgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the client?

Semi-Fowler with the head supported on two pillows

Which group of clients should not receive potassium iodide?

Those who are allergic to seafood

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Tetany

A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?

Tracheostomy set

A patient with thyroiditis has undergone surgery and is concerned about the barely visible scar. Which of the following suggestions should the nurse give the patient to cope with the condition?

Wear clothing that covers the neck.

Which findings should a nurse expect to assess in client with Hashimoto's thyroiditis?

Weight gain, decreased appetite, and constipation

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:

decreased body temperature and cold intolerance.

The nurse is completing discharge teaching with a client with hyperthyroidism who has been treated with radioactive iodine at an outpatient clinic. The nurse instructs the client to

monitor for symptoms of hypothyroidism.