A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)

You will take medication for this condition for several months

This condition can cause you to gain weight

We will perform laboratory tests to monitor the effect of your medication

You might notice that you perspire more with this condition

You will need to eat a high-fiber diet to prevent complications of this condition

Answer and Explanation

Correct Answer : B,C,E

Choice A reason: Hypothyroidism requires lifelong levothyroxine because the thyroid gland doesn’t regain function in most cases, such as Hashimoto’s disease. Stating several months misleads the client, implying a temporary treatment, which is inaccurate. This chronic condition demands continuous hormone replacement to maintain metabolism, energy, and organ function. Temporary therapy applies to transient conditions, not primary hypothyroidism, so this statement fails to reflect the long-term nature of management needed.

Choice B reason: Hypothyroidism slows metabolism due to low thyroid hormone levels, reducing basal metabolic rate and calorie burning. This leads to weight gain as energy expenditure drops, even with unchanged diet, a common symptom. Educating clients about this helps them understand and manage expectations, linking it to the condition’s physiology. It’s a key teaching point, as weight gain often prompts diagnosis and motivates adherence to levothyroxine therapy.

Choice C reason: Laboratory tests like TSH and free T4 are essential to monitor levothyroxine’s effectiveness in hypothyroidism, ensuring the dose restores euthyroid status. These tests, typically done every 6-12 weeks initially then annually, guide adjustments to prevent under- or over-treatment. Including this in teaching empowers clients to participate in their care, understanding why follow-ups matter. It reflects standard practice for managing this endocrine disorder accurately.

Choice D reason: Increased perspiration is a hyperthyroidism symptom, where excess thyroid hormone accelerates metabolism, raising body heat. Hypothyroidism, conversely, causes cold intolerance and dry skin due to slowed metabolism, reducing sweat production. This statement contradicts hypothyroidism’s physiology, misinforming the client about expected symptoms. Correct teaching would highlight cold sensitivity instead, aligning with the condition’s impact on thermoregulation and skin.

Choice E reason: Hypothyroidism slows gastrointestinal motility due to decreased thyroid hormone, often causing constipation as a complication. A high-fiber diet increases bulk and promotes bowel movements, preventing this issue. Teaching this dietary adjustment addresses a common, manageable symptom, improving quality of life. It’s a scientifically supported recommendation, as fiber counteracts the sluggish digestion typical in hypothyroid states, making it vital education.

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Correct Answer is C

Explanation

Choice A reason: Removing weights during repositioning disrupts skeletal traction’s constant pull, risking fracture misalignment or delayed healing. Traction maintains bone stability via weights and pulleys, essential for immobilization. Lifting the client without weights negates this, potentially shifting the fracture site. This action contradicts traction principles, compromising treatment efficacy and patient outcomes, making it unsafe and incorrect.

Choice B reason: Cleansing pin sites with hydrogen peroxide damages healthy tissue and delays healing by disrupting granulation, despite its antiseptic properties. Sterile saline or chlorhexidine is preferred, preserving skin integrity around traction pins. This outdated practice increases infection risk ironically, as tissue breakdown invites pathogens. It’s not aligned with current evidence-based care, rendering it inappropriate.

Choice C reason: Inspecting pin sites daily for redness, swelling, or pus detects infection early, a common traction complication like osteomyelitis. Chemotherapy or immobility heightens this risk, and prompt identification allows intervention, protecting bone health. This action aligns with standards, ensuring the fracture heals without secondary issues. It’s a proactive, essential step in traction management.

Choice D reason: Checking ropes every 8 hours ensures traction equipment integrity, preventing sudden weight drops that could misalign the fracture. While important, it’s secondary to infection monitoring, as fraying is less immediate than sepsis risk. Daily pin checks address a more urgent threat to healing. This action, though useful, isn’t the top priority here.

A. Verify the solution with another RN prior to infusion B. Monitor serum blood glucose during infusion C. Increase the rate of infusion if administration is delayed D. Infuse 0.9% sodium chloride if the solution is not available E. Obtain the client’s weight daily

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Verifying TPN with another RN is a safety protocol for this high-risk, complex solution containing dextrose, amino acids, and lipids. Errors in formulation or additives can cause severe metabolic imbalances or infections. This double-check reduces risks, ensuring the prescribed nutrients match the bag’s contents. It’s a standard of care in TPN administration, protecting the client from potential harm due to preparation mistakes, especially given its central line delivery.

Choice B reason: TPN’s high dextrose content elevates blood glucose, risking hyperglycemia, especially in stressed or diabetic clients. Monitoring serum glucose during infusion allows timely insulin adjustments, preventing complications like osmotic diuresis or ketoacidosis. This action aligns with metabolic management, as TPN bypasses digestion, delivering glucose directly into the bloodstream. Regular checks ensure glycemic control, a critical aspect of safe parenteral nutrition therapy.

Choice C reason: Increasing the TPN infusion rate to catch up if delayed is dangerous, risking fluid overload, electrolyte shifts, and refeeding syndrome. TPN rates are calculated precisely based on caloric and fluid needs, administered via infusion pumps for consistency. Speeding it up disrupts this balance, potentially causing cardiac strain or metabolic chaos. This action violates administration guidelines, making it inappropriate and unsafe.

Choice D reason: Infusing 0.9% sodium chloride instead of TPN lacks calories, amino acids, and lipids, interrupting nutritional support and risking hypoglycemia from prior high-glucose TPN. Protocol recommends 10% dextrose if TPN is unavailable, maintaining some glucose input. Sodium chloride only provides hydration, not sustenance, undermining TPN’s purpose. This substitution fails to meet the client’s metabolic needs, rendering it an incorrect action.

Choice E reason: Daily weights assess fluid balance and nutritional efficacy in TPN clients, detecting overhydration (weight gain) or malnutrition (loss). TPN delivers precise fluid and calories, and weight changes signal adjustments needed in therapy. This non-invasive measure tracks trends, complementing lab data, and is a cornerstone of monitoring. It ensures the treatment meets goals without causing volume-related complications, making it essential.

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A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is ["A","B","E"]

Explanation

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