A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism.

Which of the following laboratory values should the nurse anticipate an elevation of?

Free T4

Serum T3

Serum T4

Thyroid stimulating hormone (TSH)

Answer and Explanation

The Correct Answer is D

A.   In primary hypothyroidism, the thyroid gland fails to produce sufficient thyroid hormone.
Consequently, free T4 levels are typically decreased.
B.   Although serum T3 levels may also decrease in primary hypothyroidism due to impaired thyroid function, TSH is the primary marker used for diagnosis and monitoring.
C.   Similarly, serum T4 levels may decrease in primary hypothyroidism due to decreased synthesis by the thyroid gland.
D.   In primary hypothyroidism, the anterior pituitary gland releases more TSH to stimulate the thyroid gland to produce thyroid hormones. Therefore, elevated TSH levels are characteristic of primary hypothyroidism.

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Correct Answer is A

Explanation

A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.

A. pH 7.55, HCO 30 mEq/L PaCO 31 mm Hg B. pH 7.50, HCO 20 mEq/L, PaCO2 32 mm Hg C. pH 7.25, HCO 19 mEq/L. PaCO, 30 mm Hg D. pH 7.30, HCO: 26 mEq/L, PaCO, 50 mm Hg

Correct Answer is C

Explanation

A. The pH is alkalotic, and the PaCO2 is within the normal range, indicating respiratory alkalosis, which is not typically seen in chronic kidney disease.
B. The pH is alkalotic, and the HCO3 level is lower than normal, indicating metabolic acidosis, which can occur in chronic kidney disease, but the PaCO2 is not typically decreased in metabolic acidosis.
C. This choice fits the pattern of metabolic acidosis commonly seen in CKD patients. In patients with chronic kidney disease (CKD), the kidneys are less able to excrete acid, leading to metabolic acidosis. Therefore, the expected arterial blood gas values would show a lower pH indicating acidemia, a decreased bicarbonate (HCO3-) level, and a normal or low partial pressure of carbon dioxide (PaCO2) as the lungs try to compensate by blowing off CO2.
D. The pH is acidic, and the HCO3 level is within the normal range, indicating respiratory acidosis, which is not typically seen in chronic kidney disease.

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A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

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A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism.

Which of the following laboratory values should the nurse anticipate an elevation of?