A client who has hypothyroidism will be undergoing surgery for a total knee replacement. When planning care for this client, the nurse understands which of the following to be true for people who have hypothyroidism?

They are more prone to hyperthermia and may require cooling measures.

Their levothyroxine should be held for 3 days prior to and after the surgery.

They are at risk of developing tachycardia and should be given propranolol.

They are more sensitive to the effects of opioids and may require lower doses.

Answer and Explanation

The Correct Answer is D

A. They are more prone to hyperthermia and may require cooling measures: Hypothyroidism typically leads to hypothermia (lower body temperature) rather than hyperthermia. Clients with hypothyroidism are more likely to experience difficulty maintaining normal body temperature.
B. Their levothyroxine should be held for 3 days prior to and after the surgery: Levothyroxine should not be held before or after surgery without specific guidance from the healthcare provider. Maintaining consistent thyroid hormone levels is crucial for clients with hypothyroidism.
C. They are at risk of developing tachycardia and should be given propranolol: Hypothyroidism is more commonly associated with bradycardia (slow heart rate) rather than tachycardia (fast heart rate). Propranolol is used to manage symptoms of hyperthyroidism, not hypothyroidism.
D. They are more sensitive to the effects of opioids and may require lower doses: Clients with hypothyroidism often have a reduced metabolic rate, which can increase their sensitivity to medications, including opioids. Therefore, they may require lower doses of opioids to avoid adverse effects.

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Correct Answer is ["B","C","G"]

Explanation

A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.

A. Hyperthermia B. Hyperlipidemia C. Agitation D. Insomnia

Correct Answer is B

Explanation

A. Hyperthermia: This is not commonly associated with hypothyroidism. Hypothyroidism is more likely to lead to a decreased metabolic rate and hypothermia rather than hyperthermia.
B. Hyperlipidemia: This is a common condition associated with hypothyroidism. Hypothyroidism can lead to increased levels of cholesterol and triglycerides due to decreased metabolism.
C. Agitation: Hypothyroidism typically presents with symptoms such as fatigue and depression rather than agitation. Agitation is more commonly associated with hyperthyroidism.
D. Insomnia: Insomnia is more often associated with hyperthyroidism. Hypothyroidism usually leads to symptoms like fatigue and sleepiness rather than insomnia.

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A client who has hypothyroidism will be undergoing surgery for a total knee replacement. When planning care for this client, the nurse understands which of the following to be true for people who have hypothyroidism?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.

Correct Answer is ["B","C","G"]

Explanation

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

Correct Answer is B

Explanation

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