A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
The TSH is high because of the low production of T4 by the thyroid.
The thyroxine level is low because the TSH level is high.
The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
High thyroxine levels normally occur in breastfeeding infants.
The Correct Answer is A
In a normal infant, T4 levels increase after birth due to stimulation by TSH from the pituitary gland. In this case, the T4 level is low and the TSH level is high, indicating that the thyroid gland is not producing enough T4 in response to TSH stimulation. This suggests that the infant may have congenital hypothyroidism, which requires prompt treatment to prevent developmental delays and other complications.
The low T4 level is not a direct cause of the high TSH level; rather, the high TSH level is a compensatory mechanism to increase T4 production. It is not normal for a breastfeeding infant to have high thyroxine levels. While the thyroid gland may take a few weeks to reach normal function after birth, the persistent low T4 and high TSH levels in this infant suggest a more serious issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
During the initial phase of treatment for osteomyelitis, the nurse should instruct the child and parent to ensure that there is no weight bearing on the affected extremity. This may require the use of assistive devices such as crutches or a wheelchair. Administering topical antibiotic therapy, providing passive range of motion exercises, and scheduling ice pack applications to the infected area are not appropriate interventions during the initial phase of treatment.
Topical antibiotics may be used later in the course of treatment, after the initial phase of intravenous antibiotics has been completed.
Passive range of motion exercises may be appropriate during the later phases of treatment to prevent joint contractures.
Ice pack applications may be appropriate for pain relief, but they are not a primary intervention for osteomyelitis.
Correct Answer is B
Explanation
Information about the child's reactions to any previous hospitalizations would be particularly helpful in planning care for this six-year-old girl who is being admited for repair of an umbilical hernia. This information can help the nurse anticipate and address any fears or concerns the child may have about the hospitalization and procedure.
A list of achievement timeline for developmental milestones is not particularly relevant in this situation.
A history of rubella, rubeola, or chicken pox is not particularly relevant in this situation.
Information about the mother's use of alcohol, drugs, or cigaretes during pregnancy is not particularly relevant in this situation.
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