EAQ 4
A nurse is caring for a client after a thyroidectomy. Which symptoms indicating thyroid storm should the nurse monitor the client for? SATA a. Increased HR b. Increased temperature c. Decreased respirations d. Increased pulse deficit e. Decreased BP
a. Increased HR b. Increased temperature Thyroid storm is severe hyperthyroidism; excessive amounts of thyroxine increase the metabolic rate, thereby causing an increased heart rate (tachycardia). Because of the increased metabolic rate associated with thyroid storm, body temperature will increase. Because of the increased metabolic rate associated with thyroid storm, the respiratory rate increases (tachypnea) to meet the body's oxygen needs. Pulse deficit, the difference between apical and peripheral pulse rates, is not indicative of thyroid storm. The blood pressure will increase to meet the oxygen demand caused by the increased metabolic rate during thyroid storm.
A nurse is collecting information about a client with type 1 diabetes who is being admitted because of diabetic ketoacidotic coma. Which factors can predispose a client to this condition? SATA a. Taking too much insulin b. Getting too much exercise c. Excessive emotional stress d. Running a fever with the flu e. Eating fewer calories than prescribed
c. Excessive emotional stress d. Running a fever with the flu
A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing? a. Ketoacidosis b. Somogyi phenomenon c. Hypoglycemic reaction d. Hyperosmolar nonketotic coma
a. Ketoacidosis Ketoacidosis occurs when insulin is lacking and carbohydrates cannot be used for energy; this increases the breakdown of protein and fat, causing deep, rapid respirations (Kussmaul respirations), decreased alertness, decreased circulatory volume, metabolic acidosis, and an acetone breath. The Somogyi phenomenon is a rebound hyperglycemia induced by severe hypoglycemia; there are not enough data to determine whether this occurred. Hypoglycemia is manifested by cool, moist skin, not hot, dry skin; Kussmaul respirations do not occur with hypoglycemia. Hyperosmolar nonketotic coma usually occurs in clients with type 2 diabetes because available insulin prevents the breakdown of fat.
A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? SATA a. Leg ulcers b. Loss of visual acuity c. Increased creatinine clearance d. Prolonged cap refill in the toes e. Decreased sensation in the lower extremities
a. Leg ulcers b. Loss of visual acuity d. Prolonged cap refill in the toes e. Decreased sensation in the lower extremities Ulcers of the legs are a common response to the microvascular and macrovascular changes associated with diabetes. Retinopathy, damage to the microvascular system of the retina (e.g., edema, exudate, and local hemorrhage), occurs as a result of occlusion of the small vessels, causing microaneurysms in the capillary walls. Macrovascular changes in the distal capillary beds interfere with blood flow to the distal extremities. Decreased sensation in the lower extremities is a complication of diabetes. Consistent hyperglycemia causes a buildup of sorbitol and fructose in the nerves that causes impairment via an unknown process. Creatinine clearance decreases, not increases, as renal function deteriorates in response to microvascular damage to the small blood vessels that supply the glomeruli.
A nurse is caring for a client who is experiencing an underproduction of thyroxine (T4). Which client response is associated with an underproduction of thyroxine? a. Myxedema b. Acromegaly c. Graves Disease d. Cushing disease
a. Myxedema Myxedema is the severest form of hypothyroidism. Decreased thyroid gland activity means reduced production of thyroid hormones. Acromegaly results from excess growth hormone in adults once the epiphyses are closed. Graves disease results from an excess, not a deficiency, of thyroid hormones. Cushing disease results from excess glucocorticoids.
What interventions should the nurse implement in caring for a client with diabetes insipidus (DI) following a head injury? SATA a. Providing adequate fluids within easy reach b. Reporting an increasing urine specific gravity c. Administering prescribed erythromycin d. Assessing for and reporting changes in neurological status e. Monitoring for constipation, weight loss, hypotension, and tachycardia
a. Providing adequate fluids within easy reach d. Assessing for and reporting changes in neurological status e. Monitoring for constipation, weight loss, hypotension, and tachycardia Diabetes insipidus is a condition resulting in underproduction of antidiuretic hormone. The focus of care is on maintaining fluids and electrolytes. Oral fluids must be easily accessible at the bedside to balance urinary losses and prevent severe dehydration. The nurse monitors for, and reports, changes in neurological status associated with hypernatremia and high serum osmolality. Constipation and weight loss indicate fluid volume deficit and must be reported. Hypotension and tachycardia are signs of impending shock. Massive polyuria results in dilute urine. Decreasing urine specific gravity must be reported. There is no indication that an antibiotic is required; therefore erythromycin would not be prescribed. The primary pharmacologic treatment for diabetes insipidus, then, is replacement of antidiuretic hormone (ADH) with an exogenous vasopressin, such as desmopressin acetate (DDAVP).
What interventions should the nurse implement when caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH)? SATA a. Providing frequent oral care b. Instituting fall risk precautions c. Restricting fluids to 2L/day d. Placing the client in high-fowler postion e. Monitoring for and reporting neurologic changes
a. Providing frequent oral care b. Instituting fall risk precautions e. Monitoring for and reporting neurologic changes The excess production of antidiuretic hormone associated with SIADH leads to increased water reabsorption by the kidneys. Increased water reabsorption results in decreased urinary output, increased intravascular fluid volume, serum hypoosmolality, and dilutional hyponatremia. Because treatment includes restricting fluids, frequent oral care is provided to increase client comfort. Fall risk precautions are instituted to protect the client from injury that might occur as a result of neurologic changes associated with declining serum sodium. The nurse monitors for and reports changes in neurologic status resulting from cerebral edema and hyponatremia. Immediate treatment goals are to restore normal fluid balance and normal serum osmolality. Fluids are restricted to no more than 1000 mL and to no more than 500 mL for the client with severe hyponatremia. Treatment of SIADH includes placing the bed flat or elevating the head of the bed no more than 10 degrees. This position promotes venous return to the heart, which increases left ventricular filling pressure. Increasing left ventricular filling pressure stimulates osmoreceptors to send a message to the pituitary (via the hypothalamus) that antidiuretic hormone release should be decreased.
A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes, and the other client has type 2 diabetes. When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1? a. Onset of the disease is slow b. Excessive weight is a contributing factor c. Complications are not present at the time of diagnosis d. Treatment involves diet, exercise, and oral medications
c. Complications are not present at the time of diagnosis Clinical presentation of type 1 diabetes is characterized by acute onset, and therefore there is no time to develop the long-term complications that are common with long-standing disease; 20% of newly diagnosed clients with type 2 diabetes demonstrate complications because the diabetes has gone undetected for an extended period of time. Clinical presentation of type 1 diabetes is rapid, not slow, as pancreatic beta cells are destroyed by an autoimmune process; in type 2 diabetes, the body is still producing some insulin, and therefore the onset of signs and symptoms is slow. In type 1 diabetes, clients are generally lean or have an ideal weight; 80% to 90% of clients with type 2 diabetes are overweight. Type 1 diabetes requires diet control, exercise, and subcutaneous administration of insulin, not oral medications; oral medications are used for type 2 diabetes because some insulin is still being produced.
A 9-year-old child who has had type 1 diabetes for several years is brought to the emergency department of a community hospital. The child is exhibiting deep, rapid respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst. What blood pH and glucose level does the nurse expect the laboratory tests to reveal? a. 7.20 and 60 mg/dL (3.3 mmol/L) b. 7.50 and 60 mg/dL (3.3 mmol/L) c. 7.50 and 460 mg/dL (25.5 mmol/L) d. 7.20 and 460 mg/dL (25.5 mmol/L)
d. 7.20 and 460 mg/dL (25.5 mmol/L) A pH of 7.20 and blood glucose level of 460 mg/dL (25.5 mmol/L) are expected values in ketoacidosis; the pH of 7.20 indicates acidosis (metabolic), and the blood glucose level of 460 mg/dL (25.5 mmol/L) is higher than the expected range of 90 to 110 mg/dL (5.0 to 6.1 mmol/L) . Although the blood pH of 7.20 indicates acidosis, the blood glucose of 60 mg/dL (3.3 mmol/L) is less than the expected range of 90 to 110 mg/dL (5.0 to 6.1 mmol/L), indicating hypoglycemia rather than hyperglycemia. Neither the pH of 7.50 nor the blood glucose value of 60 mg/dL (3.3 mmol/L) is expected with ketoacidosis; with ketoacidosis, the pH is decreased, and the blood glucose level is increased. Although the blood glucose is increased with ketoacidosis, the pH is decreased, not increased; a pH of 7.50 indicates alkalosis.
After treatment with propylthiouracil for hyperthyroidism, a client has the thyroid ablated with 131I. On a visit to the endocrine clinic, the client exhibits signs and symptoms of thyrotoxic crisis (thyroid storm). What does the nurse identify as the likely cause of thyrotoxic crisis? a. Deficiency of iodine b. Decreased serum calcium c. Increased Na retention d. Excessive hormone replacement
d. Excessive hormone replacement Thyrotoxic crisis (thyroid storm) is the body's response to excessive circulating thyroid hormones. A deficiency of iodine results in a deficiency in thyroid hormone production. A decreased serum calcium causes tetany. Sodium retention is unrelated to thyrotoxic crisis; thyrotoxic crisis is caused by excessive circulating thyroid hormones.
The nurse is caring for four different clients admitted with fluid overload. Which client should be considered a priority requiring immediate care? Client A: 88 y/o with a bounding pulse rate Client B: 12 y/o with pale skin and pitting edema Client C: 21 y/o with a severe headache Client D: 36 y/o with increased GI motility. a. Client A b. Client B c. Client C d. Client D
a. Client A Client A is an elderly person who presents with a bounding pulse rate due to fluid overload in the body. Care should be prioritized in this client because the condition of the client indicates increasing fluid overload and needs immediate treatment. Vital signs should be monitored properly to identify other associated risks. Client B has pale skin with pitting edema, so this client should be given second priority for treatment and an oxygen mask or nasal cannula should be provided. Client C can be given medications to relieve the headache due to fluid overload. Client D should be given nutritional therapy to treat fluid overload.
A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed. What does the nurse recognize as the primary purpose of the IV insulin for this client? a. Correct hyperkalemia b. Increase urinary output c. Prevent respiratory acidosis d. Increase serum calcium levels
a. Correct hyperkalemia The 50% glucose and regular insulin infusion treats the hyperkalemia associated with kidney failure; it moves potassium from the intravascular compartment into the intracellular compartment. Insulin will not increase urinary output. Insulin is not a treatment for respiratory acidosis. Insulin and glucose do not increase serum calcium levels.
A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication? a. Hypotension b. Hyperglycemia c. Sodium retention d. Potassium excretion
a. Hypotension Because of instability of the vascular system and the lability of circulating adrenal hormones after an adrenalectomy, hypotension frequently occurs until the hormonal level is controlled by replacement therapy. Hyperglycemia is a sign of excessive adrenal hormones; after an adrenalectomy, adrenal hormones are not secreted. Sodium retention is a sign of hyperadrenalism; it does not occur after the adrenals are removed. Potassium excretion is a response to excessive adrenal hormones; after an adrenalectomy is performed, adrenal hormones are lowered until replacement therapy is regulated.
A nurse is caring for a client with hypoglycemia. Which nursing intervention would be appropriate in managing the client's condition? SATA a. Administering insulin b. Administering glucagon c. Administering IV glucose d. Administering oral hydrocortisone e. Administering somatostatin
b. Administering glucagon c. Administering IV glucose d. Administering oral hydrocortisone A client with hypoglycemia suffers with weakness and vision disturbances due to low glucose levels. Glucagon is the hormone secreted by the pancreas that helps with increasing the blood glucose levels. Administering IV glucose would immediately improve the blood glucose levels. Hydrocortisone is a glucocorticoid that prevents hypoglycemia by increasing liver gluconeogenesis and inhibiting peripheral glucose use. Insulin is administered when glucose levels are high as it increases the glucose reuptake, thereby reducing blood glucose levels. Somatostatin is a hormone released by delta cells of the pancreas that inhibits insulin and glucagon.
A 13-year-old child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. At what time does the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur? a. Before noon b. In the afternoon c. Within 30 minutes d. During the evening
b. In the afternoon NPH insulin is an intermediate-acting insulin that peaks approximately 6 to 8 hours after administration. It was administered at 7:00 AM, so between 1:00 and 3:00 PM is when the nurse should anticipate that a hypoglycemic reaction will occur. Noon is when a reaction from a short-acting insulin is expected. Short-acting insulin peaks in 2 to 4 hours after administration. Within 30 minutes of administration is when a reaction from a rapid-acting insulin is expected. Rapid-acting insulin peaks 30 to 60 minutes after administration. During the evening or night is when a reaction from a long-acting insulin is expected. Long-acting insulin has a small peak 10 to 16 hours after administration.
A nurse plans to set up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy. What should the nurse include in the bedside setup? a. Crash cart with bed board b. Trach set and oxygen c. Ampule of sodium bicarbonate d. Airway and nonrebreather mask
b. Trach set and oxygen A tracheostomy set and oxygen are necessary if the client experiences an acute respiratory obstruction as a result of postoperative edema, nerve damage, or tetany. A cardiac arrest is not an expected response after thyroid surgery. Acidosis requiring sodium bicarbonate and cardiac arrest are not expected responses after a thyroidectomy. If the airway is obstructed by postoperative edema, the use of a mechanical airway will be ineffective because it will not reach beyond the point of the obstruction. A nonrebreather mask is designed to deliver high concentrations of oxygen. In the event of an airway obstruction, the client's need is to circumvent the obstruction, not deliver high concentrations of oxygen.
The nurse is caring for a client newly diagnosed with diabetes. When preparing the teaching plan about the importance of yearly eye examinations, the nurse should instruct the client on which eye problem most associated with diabetes? a. Cataracts b. Glaucoma c. Retinopathy d. Astigmatism
c. Retinopathy Diabetic retinopathy is a leading cause of blindness in diabetics. Glaucoma and cataracts also are associated with diabetes, but retinopathy is the most common eye problem. Astigmatism is not associated with diabetes.
A client has undergone nasal hypophysectomy surgery. During post-operative care, which finding indicates cerebrospinal leakage? a. Dry mouth b. Rigidity of neck muscles c. Fall in BP upon standing d. A yellow edge around nasal discharge
d. A yellow edge around nasal discharge Nasal hypophysectomy is a surgical procedure performed to treat hyperpituitarism due to pituitary gland tumors. During postoperative care and follow-up, the appearance of light-yellow at the edge of otherwise clear nasal discharge in the dressing indicates leakage of cerebrospinal fluid (CSF). This is called the "halo sign" and is indicative of a CSF leak. Dry mouth after nasal hypophysectomy is normal because the client breathes through the mouth due to the nasal packing. Neck rigidity could be an indication of infection, such as meningitis following the surgery. A fall in blood pressure upon standing is called orthostatic hypotension and is a side effect of bromocriptine.
A 15-year-old adolescent is found to have type 1 diabetes. What should the nurse include when teaching the adolescent about type 1 diabetes? a. It does not always require insulin b. It involves early vascular changes c. It occurs more often in obese adolescents d. It has a more rapid onset than does type 2 diabetes
d. It has a more rapid onset than does type 2 diabetes A characteristic difference between type 1 and type 2 diabetes is the rapid onset of type 1 diabetes. Type 1 diabetes often is first diagnosed during an episode of acute ketoacidosis. Children, adolescents, and adults with type 1 diabetes are insulin dependent. Vascular changes are complications associated with long-standing diabetes. Maturity-onset diabetes of the young (MODY), similar to type 2 diabetes, is more often seen in obese teenagers. Adolescents with type 1 diabetes tend to be at or below the expected weight for their height and bone structure.
The nurse is teaching a client about safe insulin administration. Which statement made by the client indicates the need for further education? a. "I should see whether the insulin is expired" b. "I should keep a daily logbook of times of insulin injection" c. "I should keep my medication in its original labeled container" d. "I should administer insulin only if there are any symptoms"
d. "I should administer insulin only if there are any symptoms" The client should administer insulin throughout his or her lifetime and should maintain the dose and daily schedule as ordered by the primary healthcare provider. Before administering insulin, the client should check the expiration date. The client should maintain a daily logbook of insulin injections. The client should keep the medication in its original labeled container and refrigerate if needed.
The nurse is caring for a client with diabetes mellitus who is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. What does the nurse recognize as the only type of insulin that is compatible with intravenous solutions? a. NPH Insulin b. Insulin lispro c. Regular insulin d. Insulin glargine
c. Regular insulin Regular insulin acts rapidly, is approved for IV administration, and is compatible with intravenous solutions. Insulin lispro is not compatible with intravenous solutions; it is a rapid-acting insulin. Insulin glargine is not compatible with intravenous solutions; it is a long-acting insulin. NPH insulin is not compatible with intravenous solutions; it is an intermediate-acting insulin.
A nurse is assessing a female client with Cushing syndrome. Which clinical findings can the nurse expect to identify? SATA a. Hirsutism b. Menorrhagia c. Buffalo hump d. Dependent edema e. Migraine headache
a. Hirsutism c. Buffalo hump Excessive hairiness, especially a male pattern of hair distribution on a woman (hirsutism), occurs with Cushing syndrome because of an androgen excess. Cushing syndrome results from excess adrenocortical activity. Hypercortisolism causes fat redistribution, resulting in "buffalo hump"; it also contributes to slow wound healing, hirsutism, weight gain, hypertension, acne, thin arms and legs, and behavioral changes. Menorrhagia (excessive menstrual bleeding) does not occur; menses may cease or be scanty because of virilization. Edema does not occur except when severe heart failure is present. Headaches do not occur with this syndrome.
An older adult with a history of small cell lung carcinoma reports muscle cramping, thirst, and fatigue. The primary healthcare provider diagnoses the client with a pituitary disorder and is treating the client accordingly. Which is an effective outcome of the treatment? a. Urine output of 10 L/day b. Urine specific gravity less than 1.025 c. Urine osmolarity of 80 mOsm/kg d. Serum osmolarity of 600 mOsm/kg
b. Urine specific gravity less than 1.025 Because the specific gravity is less than 1.025 after treatment, the outcome is considered positive. In syndrome of inappropriate antidiuretic hormone (SIADH), the specific gravity is greater than 1.025. Small cell lung cancer is a risk factor of SIADH. Muscle cramping, thirst, and fatigue are clinical manifestations of SIADH. A serum osmolarity of 600 mOsm/kg indicates central diabetes insipidus. A urine output 10 L/day and a urine osmolarity of 80 mOsm/kg indicate diabetes insipidus.
The nurse is providing care for a client with small-cell carcinoma of the lung who develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What clinical findings correspond with the secretion of antidiuretic hormone (ADH)? SATA a. Edema b. Polyuria c. Bradycardia d. Hypotension e. Hyponatremia
a. Edema e. Hyponatremia Edema results as fluid is retained because of the increased secretion of antidiuretic hormone. ADH causes water retention, which dilutes serum electrolytes such as sodium, with a resultant hyponatremia. A decreased urine output occurs with SIADH because ADH causes reabsorption of fluid in the kidney glomeruli. The increased fluid volume associated with SIADH results in tachycardia, tachypnea, and crackles. The increased fluid volume associated with SIADH results in hypertension, not hypotension.
Why does the nurse teach the parents of a young child with type 1 diabetes how to test the child's urine at home during periods of stress or illness, even though blood glucose testing is being done four times a day? a. Urine should be tested for acetone during illness and when the blood glucose level is increased b. Blood glucose testing before meals and at bedtime may be stopped once the child is stabilized on insulin c. Urine testing remains the most accurate way to check for a high glucose level if double-voided specimens are used d. The short term glucose level is more accurately reflected in a urine specimen than in a blood specimen, especially in children
a. Urine should be tested for acetone during illness and when the blood glucose level is increased Urine testing is primarily helpful in detectingacetone (the simplest ketone), which are most likely to be present during illness and hyperglycemia.. Because of the complexity of the diabetic regimen and the variety of factors that influence the serum glucose level (e.g., food ingested, exercise, medications, and the stresses of growth and development), serum glucose levels in children can fluctuate; therefore the serum glucose level should be checked before meals and at bedtime. Blood, not urine, is the best specimen with which to determine the glucose level.
The nurse is giving discharge teaching to a client with diabetes who has had a hypophysectomy. Which statement made by the client indicates that further teaching is necessary? a. "There is a risk that I could become permanently sterile" b. "My insulin dose will need to be increased from now on" c. "I must have cortisone therapy for the rest of my life" d. "Lifelong thyroxine replacement therapy will be required"
b. "My insulin dose will need to be increased from now on" Surgical removal of the hypophysis (pituitary gland) will reduce follicle-stimulating (FSH), luteinizing (LH), adrenocorticotropic (ACTH), and thyroid-stimulating (TSH) hormone levels. Infertility would be expected because FSH and LH will no longer stimulate spermatogenesis or oogenesis. Without ACTH, cortisone administration will be required to avoid Addisonian crisis. Without TSH, thyroxine replacement therapy will be necessary to avoid myxedema coma. In general, insulin release is regulated by blood glucose and not directly by the pituitary gland. Also, because somatotropin release by the pituitary stops after the hypophysectomy, it cannot cause a blood glucose level elevation so there will be no need to increase the insulin dosage due to the surgery alone.
Which insulin should the nurse prepare for the emergency treatment of ketoacidosis? a. Glargine b. NPH Insulin c. Insulin aspart d. Insulin detemir
c. Insulin aspart Insulin aspart is a rapid-acting insulin (within 10 to 20 minutes) and is used to meet a client's immediate insulin needs. Glargine is a long-acting insulin, which has an onset of 1.5 hours; for diabetic acidosis, the individual needs rapid-acting insulin. NPH insulin is an intermediate-acting insulin, which has an onset of 1 to 2 hours; for diabetic acidosis, the individual needs rapid-acting insulin. Insulin detemir is a long-acting insulin; for diabetic acidosis, the individual needs rapid-acting insulin
The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? SATA a. It prevents ketoacidosis b. It helps cause weight loss c. It can improve A1C levels d. An insulin pump costs less than SUBQ injections e. Clients may be able to exercise without eating more carbohydrates
c. It can improve A1C levels e. Clients may be able to exercise without eating more carbohydrates Maintaining a consistent acceptable blood glucose level will improve A1C results. Because insulin is administered only as needed, the client will be able to exercise without having to increase the carbohydrate intake. Ketoacidosis may occur if the catheter becomes dislodged and the client does not receive insulin for hours. Insulin pumps can cause weight gain, not loss. An insulin pump is more expensive than subcutaneous insulin injections.
Two clients with polydipsia and polyuria arrived at the hospital. Both were having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment finding helped to differentiate the diagnosis? a. Urine output b. Specific gravity c. Urine osmolarity d. Serum osmolarity
c. Urine osmolarity Polydipsia and polyuria are signs of diabetes insipidus. When a water deprivation test is performed, urine osmolarity is increased dramatically from 100 to 600 mOsm (mmol)/kg in clients with central diabetes insipidus. But in nephrogenic diabetes insipidus, the urine osmolarity may not be greater than 300 mOsm (mmol)/kg. The urine output is 2 L to 20 L/day in all types of diabetes insipidus. The specific gravity is less than 1.005 in all types of diabetes insipidus and the serum osmolarity is also greater than 295 mOsm (mmol)/kg in all types of diabetes insipidus.
A client is admitted to the hospital with the diagnosis of cancer of the thyroid, and a thyroidectomy is scheduled. What is important for the nurse to consider when caring for this client during the postoperative period? a. Hypercalcemia may result from parathyroid damage b. Hypotension and bradycardia may result from thyroid storm c. Tetany may result from underdosage of thyroid hormone replacement d. Hoarseness and airway obstruction may result from laryngeal nerve damage
d. Hoarseness and airway obstruction may result from laryngeal nerve damage Laryngeal nerve injury can cause laryngeal spasms, resulting in airway obstruction. Parathyroid damage results in hypocalcemia, not hypercalcemia. Thyroid storm (thyroid crisis) is characterized by the release of excessive levels of thyroid hormone, which increases the metabolic rate. An increase in the metabolic rate increases vital signs, resulting in hypertension, not hypotension, and tachycardia, not bradycardia. Tetany is caused by a decrease in parathormone, a parathyroid hormone, not a thyroid hormone.