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

Explanation

A. Weight gain and lethargy: These symptoms are more commonly associated with hypothyroidism or insufficient thyroid hormone levels, not with excess levothyroxine.
B. Nervousness and tachycardia: Excessive levothyroxine can lead to symptoms of hyperthyroidism, such as increased heart rate (tachycardia) and nervousness. These symptoms are consistent with an overdose of levothyroxine.
C. Facial puffiness and constipation: These symptoms are indicative of hypothyroidism, not hyperthyroidism. They would not be expected with an excess of levothyroxine.
D. Hypotension and intolerance to cold: These are symptoms of hypothyroidism and would not typically occur with an excess of levothyroxine. Excess levothyroxine usually causes symptoms of hyperthyroidism.

A. Levothyroxine replacement test B. Radioactive iodine uptake (RAIU) test C. Adrenocorticotropic hormone (ACTH) stimulation test D. Subtotal thyroidectomy

Correct Answer is B

Explanation

A. Levothyroxine replacement test: This test is used to assess the thyroid's response to synthetic thyroid hormone and is not used to differentiate types of hyperthyroidism.
B. Radioactive iodine uptake (RAIU) test: This test measures the thyroid gland's ability to absorb iodine, which helps differentiate Graves' disease (characterized by increased uptake) from other forms of hyperthyroidism, such as thyroiditis (which may show decreased uptake).
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test is used to evaluate adrenal function and is not relevant for diagnosing or differentiating forms of hyperthyroidism.
D. Subtotal thyroidectomy: This is a surgical procedure rather than a diagnostic test and would not be used to differentiate between types of hyperthyroidism.

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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 client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?

Correct Answer is B

Explanation

A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?

Correct Answer is B

Explanation

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