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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 B

Explanation

A. I will need to wear a medical alert bracelet at all times: This statement is correct. Clients with Addison's disease should wear a medical alert bracelet to inform healthcare providers of their condition in case of an emergency, as it could impact treatment decisions.
B. I will need to hold my hydrocortisone dose if I have an infection: This statement indicates a need for additional teaching. Clients with Addison's disease should not hold their hydrocortisone dose if they have an infection. In fact, they may need to increase their dose during periods of stress or illness to manage their condition effectively.
C. I will take my hydrocortisone tablets twice a day: This statement is correct. Hydrocortisone is typically taken in divided doses to mimic the natural release of cortisol from the adrenal glands.
D. I will need to eat a high-sodium diet: This statement is correct. Clients with Addison's disease often need to increase their sodium intake, as they may have difficulties retaining sodium due to adrenal insufficiency.

A. IV hydrocortisone B. Ketoconazole and insulin C. Lactated Ringer's IV infusion D. Furosemide slow IV push

Correct Answer is A

Explanation

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

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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

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Explanation

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Correct Answer is A

Explanation

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