A 65-year-old patient is admitted to the ICU with myxedema coma. Which of the following interventions is the priority for this patient?

Administer IV levothyroxine.

Start broad-spectrum antibiotics.

Administer corticosteroids immediately.

Initiate fluid restriction.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Administering IV levothyroxine is the priority intervention for a patient with myxedema coma. Myxedema coma is a severe form of hypothyroidism that requires immediate thyroid hormone replacement to correct the deficiency and stabilize the patient’s condition. Intravenous levothyroxine is preferred because it provides a rapid increase in thyroid hormone levels, which is crucial for reversing the life-threatening symptoms of myxedema coma, such as hypothermia, bradycardia, and altered mental status.

Choice B Reason:

Starting broad-spectrum antibiotics is not the primary intervention for myxedema coma. While infections can precipitate myxedema coma and should be treated if present, the immediate priority is to address the severe hypothyroidism with thyroid hormone replacement. Antibiotics may be administered if an infection is suspected or confirmed, but they do not directly address the underlying thyroid hormone deficiency.

Choice C Reason:

Administering corticosteroids immediately is important but not the highest priority. Corticosteroids are often given to patients with myxedema coma to treat potential adrenal insufficiency, which can coexist with severe hypothyroidism. However, the primary intervention remains the administration of thyroid hormone replacement to correct the hypothyroid state.

Choice D Reason:

Initiating fluid restriction is not appropriate for managing myxedema coma. Patients with myxedema coma often require careful fluid management to address potential hyponatremia and maintain hemodynamic stability. Fluid restriction is not a standard intervention for this condition and does not address the critical need for thyroid hormone replacement.

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Correct Answer is B

Explanation

Choice A Reason:

Night blindness, or difficulty seeing in low light, is not a primary symptom of macular degeneration. This condition primarily affects the macula, the central part of the retina responsible for sharp, central vision. Night blindness is more commonly associated with conditions like retinitis pigmentosa or vitamin A deficiency.

Choice B Reason:

Central vision loss is the hallmark of macular degeneration. This condition leads to the deterioration of the macula, causing blurred or lost central vision while peripheral vision remains intact. Patients often report difficulty reading, recognizing faces, and performing tasks that require fine visual detail3.

Choice C Reason:

Peripheral vision loss is not typically associated with macular degeneration. This condition affects the central part of the retina, leaving peripheral vision largely unaffected. Peripheral vision loss is more commonly seen in conditions like glaucoma.

Choice D Reason:

Double vision, or diplopia, is not a characteristic symptom of macular degeneration. This condition affects the clarity of central vision but does not typically cause double vision. Double vision can result from issues with the eye muscles or nerves, such as in cases of strabismus or cranial nerve palsies.

A. Allow the client to keep her hearing aids in. B. Allow the client to consume clear liquids up to the time of surgery. C. Allow the client to take her morning vitamins. D. Allow the client to keep her tongue stud in.

Correct Answer is A

Explanation

Choice A Reason:

Allowing the client to keep her hearing aids in is crucial for effective communication between the nurse and the client. Hearing aids help the client understand instructions and respond appropriately, which is essential for ensuring the client’s safety and comfort before surgery. According to preoperative guidelines, patients with hearing impairments should be allowed to use their hearing aids until they are taken to the operating room. This practice helps reduce anxiety and ensures that the client can hear and understand all preoperative instructions and consent information.

Choice B Reason:

Allowing the client to consume clear liquids up to the time of surgery is generally not recommended. Preoperative fasting guidelines typically require patients to stop consuming clear liquids at least two hours before surgery to reduce the risk of aspiration during anesthesia. Therefore, this option is not appropriate for ensuring the client’s safety.

Choice C Reason:

Allowing the client to take her morning vitamins is not advisable without specific instructions from the surgical team. Some vitamins and supplements can interact with anesthesia or increase the risk of bleeding during surgery. It is essential to follow the surgical team’s guidelines regarding medication and supplement intake before surgery.

Choice D Reason:

Allowing the client to keep her tongue stud in is not recommended. All jewelry and body piercings should be removed before surgery to prevent complications such as electrical burns during the use of electrocautery devices or interference with airway management. Removing the tongue stud is necessary to ensure the client’s safety during the procedure.

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A 65-year-old patient is admitted to the ICU with myxedema coma. Which of the following interventions is the priority for this patient?

Nursing Test Bank

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