What clinical manifestations does the nurse recognize would be associated with a diagnosis of hyperthyroidism? Select all that apply.
Weight loss.
Intolerance to cold.
An elevated systolic blood pressure.
A heart rate of 90 bpm.
Increased fatigability.
Correct Answer : A,C,E
Choice A Reason:
Weight loss.
Weight loss is a common symptom of hyperthyroidism. This condition speeds up the body’s metabolism, causing the body to burn calories more quickly than usual. Despite an increased appetite, individuals with hyperthyroidism often experience significant weight loss. This symptom is a direct result of the overproduction of thyroid hormones, which increases the metabolic rate.
Choice B Reason:
Intolerance to cold.
Intolerance to cold is not typically associated with hyperthyroidism; it is more commonly a symptom of hypothyroidism. Hyperthyroidism usually causes heat intolerance due to the increased metabolic rate, which raises the body’s temperature. Therefore, this choice is not relevant to hyperthyroidism.
Choice C Reason:
An elevated systolic blood pressure.
An elevated systolic blood pressure can be a symptom of hyperthyroidism. The increased levels of thyroid hormones can cause the heart to work harder, leading to higher blood pressure. This symptom is important to monitor as it can lead to further cardiovascular complications if left untreated.
Choice D Reason:
A heart rate of 90 bpm.
A heart rate of 90 bpm is within the normal range for adults and is not specifically indicative of hyperthyroidism. Hyperthyroidism typically causes a rapid or irregular heartbeat, often exceeding 100 bpm. Therefore, this choice does not accurately reflect a clinical manifestation of hyperthyroidism.
Choice E Reason:
Increased fatigability.
Increased fatigability is a common symptom of hyperthyroidism. Despite the increased metabolic rate, individuals with hyperthyroidism often feel tired and weak. This paradoxical symptom occurs because the body’s systems are overworked and cannot sustain the heightened activity levels, leading to fatigue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Low oxygen saturation is not a common side effect of donepezil. Donepezil is a cholinesterase inhibitor used to treat symptoms of Alzheimer’s disease by increasing the levels of acetylcholine in the brain. While it can have various side effects, respiratory issues like low oxygen saturation are not typically associated with this medication. Therefore, monitoring for low oxygen saturation is not a primary concern for patients starting donepezil.
Choice B Reason:
High blood pressure is also not a common side effect of donepezil. The medication primarily affects the central nervous system and does not typically cause significant changes in blood pressure. While it is always important to monitor a patient’s overall health, high blood pressure is not a side effect specifically linked to donepezil use. Therefore, it is not a primary focus for monitoring in this context.
Choice C Reason:
Elevated body temperature is not commonly associated with donepezil. The side effects of donepezil are more likely to involve gastrointestinal issues such as nausea, vomiting, and diarrhea, as well as muscle cramps and fatigue. Elevated body temperature is not a typical reaction to this medication, so it is not a primary concern for monitoring.
Choice D Reason:
Low pulse rate, or bradycardia, is a known side effect of donepezil. Donepezil can increase the levels of acetylcholine, which can affect the heart’s electrical conduction system and lead to a slower heart rate. This can be particularly concerning in elderly patients or those with pre-existing heart conditions. Therefore, it is crucial for the nurse to teach the family to monitor the client’s pulse rate regularly and report any significant decreases to the healthcare provider.
Correct Answer is A
Explanation
Choice A Reason:
0.45% sodium chloride (half-normal saline) is an appropriate solution for treating hypernatremia, especially in a client who is NPO (nothing by mouth). This hypotonic solution helps to gradually reduce the serum sodium levels by providing free water to the extracellular space, which dilutes the high sodium concentration. It is essential to administer this solution slowly to avoid rapid shifts in fluid balance, which can lead to cerebral edema.
Choice B Reason:
Dextrose 5% in 0.9% sodium chloride (D5NS) is not the best choice for treating hypernatremia. While it provides some free water, the presence of 0.9% sodium chloride makes it an isotonic solution, which does not effectively lower serum sodium levels. This solution is more suitable for maintaining fluid balance rather than correcting hypernatremia.
Choice C Reason:
Lactated Ringer’s is also not appropriate for treating hypernatremia. This isotonic solution contains electrolytes, including sodium, which can exacerbate hypernatremia rather than correct it. Lactated Ringer’s is typically used for fluid resuscitation and electrolyte replacement in other clinical scenarios.
Choice D Reason:
Dextrose 10% in water (D10W) is a hypertonic solution and is not suitable for treating hypernatremia. While it provides free water, the high concentration of dextrose can lead to rapid shifts in fluid balance and potential complications such as hyperglycemia. This solution is generally used for providing calories and preventing hypoglycemia in specific clinical situations.
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