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

Administer propylthiouracil (PTU).

Provide warm blankets.

Place the client on a cardiac monitor.

Place the client on a high-calorie diet.

Administer propranolol.

Administer acetaminophen.

Administer levothyroxine.

Answer and Explanation

Correct Answer : B,C,G

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.

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Correct Answer is C

Explanation

A. Acetaminophen: While acetaminophen can help manage fever, it is not a primary treatment for acute thyrotoxicosis. The management of acute thyrotoxicosis involves addressing the overproduction of thyroid hormones, not just symptom relief.
B. Furosemide: Furosemide is a diuretic used for fluid retention and hypertension, not for managing thyrotoxicosis. It does not address the underlying cause of acute thyrotoxicosis.
C. Ketoconazole: Ketoconazole is an anti-fungal medication that also has the effect of inhibiting cortisol synthesis and can be used to treat acute thyrotoxicosis by reducing the production of thyroid hormones. It is used as part of a broader treatment plan.
D. Levothyroxine: Levothyroxine is used to treat hypothyroidism by providing synthetic thyroid hormone. It is not used to treat thyrotoxicosis, which involves excessive thyroid hormone levels, not deficiency.

A. Hypercalcemia and hyperkalemia B. Muscle twitching and tingling around the mouth C. Harsh, vibratory breath sounds D. Hyperthermia and hypertension

Correct Answer is B

Explanation

A. Hypercalcemia and hyperkalemia: These are not typical indicators of parathyroid damage. Hypercalcemia usually results from overactive parathyroid glands, while hyperkalemia is not a common result of parathyroid damage.
B. Muscle twitching and tingling around the mouth: These symptoms are indicative of hypoparathyroidism, a condition that can occur if the parathyroid glands are damaged during thyroid surgery. This results in hypocalcemia (low calcium levels), which causes neuromuscular symptoms like muscle twitching and tingling.
C. Harsh, vibratory breath sounds: These are not related to parathyroid damage. They may suggest respiratory issues, not problems with calcium regulation.
D. Hyperthermia and hypertension: These are not associated with parathyroid damage. They may be related to other post-surgical complications but not specifically to parathyroid gland injury.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which pharmacologic therapy does the nurse anticipate administering to a client who is experiencing acute thyrotoxicosis?

Correct Answer is C

Explanation

A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Correct Answer is B

Explanation

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?

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

A nurse is providing dietary teaching for a client who has Graves' disease. Which of the following statements made by the client indicates a need for further teaching by the nurse?

A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?

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?

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?

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

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