The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimoto's thryoiditis. When assessing this patient, what sign or symptom would the nurse expect? Show A. Fatigue A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient? C. Semi-Fowler's with the head supported on two pillows. When moving and turning the patient, the nurse carefully supports the patient's head and avoids tension on the sutures. The most comfortable position is the semi-Fowler's position, with the head elevated and supported by pillows. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications? A. Do you feel any muscle twitches or spasms? A. Do you feel any muscle twitches or spasms? As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia. The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body? C. Table salt The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine. The nurse is caring for a patient with hyperparathyroidism. What level of activity would the nurse expect to promote? D. Ambulation and activity as tolerate. Mobility, with walking or use of a rocking chair for those with limited mobility, is encouraged as much as possible because bones subjected to normal stress give up less calcium. Bed rest should be discouraged because it increases calcium excretion and the risk of renal calculi. Limiting the patient to getting out of bed only a few times a day also increases calcium excretion and the associated risks. A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal? C. Hypocalcemia Injury or removal of the parathyroid glands may produce a disturbance in calcium metabolism and result in a decline of calcium levels (hypocalcemia). As the blood calcium levels fall, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This group of symptoms is known as tetany and must be reported to the physician immediately, because laryngospasm may occur and obstruct the airway. Hypophosphatemia, hyponatremia, and hypokalemia are not expected responses to parathyroid injury or removal. In fact, parathyroid removal or injury that results in hypocalcemia may lead to hyperphosphatemia. The nurse is planning the care of a patient with hyperthyroidism. What should the nurse specify in the patient's meal plan? B. Small, frequent meals, high in protein and calories. A patient with hyperthyroidism has an increased appetite. The patient should be counseled to consume several small, well-balanced meals. High-calorie, high-protein foods are encouraged. A clear liquid diet would not satisfy the patient's caloric or hunger needs. A diet rich in fiber and fat should be avoided because these foods may lead to GI upset or increase peristalsis. The nurse is assessing a patient
diagnosed with Graves' disease. What physical characteristics of Graves' disease would the nurse expect to find? C. Bulging eyes Clinical manifestations of the endocrine disorder Graves' disease include exophthalmos (bulging eyes) and fine tremor in the hands. Graves' disease is not associated with hair loss, a moon face, or fatigue. A nurse
works in a walk-in clinic. The nurse recognizes that certain patients are at higher risk for different disorders than other patients. What patient is at a greater risk for the development of hypothyroidism? A. 75 yo female patient with osteoporosis. Even though osteoporosis is not a risk factor for hypothyroidism, the condition occurs most frequently in older women. A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patient's diminished thyroid function may have what effect? D. prolonged duration of effect In all patients with hypothyroidism, the effects of analgesic agents, sedatives, and anesthetic agents are prolonged. There is no direct increase in the risk of anaphylaxis, nausea, or drug interactions, although these may potentially result from the prolonged half-life of drugs. A patient has been admitted to the critical care unit with a diagnosis of
thyroid storm. What interventions should the nurse include in this patient's immediate care? Select all that apply. B,D Thyroid storm necessitates interventions to reduce heart rate and temperature. Diuretics, insulin, and steroids are not indicated to address the manifestations of this health problem. The nurse's assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention? B, IV calcium gluconate When hypocalcemia and tetany occur after a thyroidectomy, the immediate treatment is administration of IV calcium gluconate. This has a much faster therapeutic effect than PO calcium or vitamin D supplements. PTH and levothyroxine are not used to treat this complication. The nurse is providing care for an older adult patient whose current medication regimen includes
levothyroxine (Synthroid). As a result, the nurse should be aware of the heightened risk of adverse effects when administering an IV dose of what medication? D, benzodiazepine Oral thyroid hormones interact with many other medications.Even in small IV doses, hypnotic and sedative agents may induce profound somnolence, lasting far longer than anticipated and leading to narcosis (stupor like condition). Furthermore, they are likely to cause respiratory depression, which can easily be fatal because of decreased respiratory reserve and alveolar hypoventilation. Antibiotics, PPIs and diuretics do not cause the same risk. A nurse is caring for a client with Graves' disease. Based on clinical manifestations, which nursing diagnosis would be most appropriate? A Clients with Graves' disease often have a startling appearance with a swollen neck, evidence of weight loss, and edematous protruding eyes. Clients may need much support to adjust to the physical changes that accompany this disease. They may have diarrhea, not constipation. In a client admitted to the clinical
unit with a sporadic goiter, the nurse might expect to find that the client C Sporadic goiter is not restricted to any geographic area. Major causes include ingestion of large amounts of nutritional goitrogens, such as rutabagas, cabbages, soybeans, peanuts, peaches, peas, strawberries, spinach, and radishes. Aspirin intake is not related. The nurse should assess a client with a history of hypothyroidism for D Myxedema is a complication of hypothyroidism characterized by a general hypometabolic state. Myxedema coma is a medical emergency that, if untreated, is nearly always fatal. Goiter is simply an enlarged thyroid gland. Graves' disease is the most common form of hyperthyroidism. Hashimoto's thyroiditis is a chronic condition. The nurse counseling a client in the prevention of goiter would suggest an increased intake of B Health promotion practices to prevent goiter include ingestion of iodized salt and avoidance of goitrogens. In the assessment of a client with hypothyroidism, the nurse would include B The most important changes caused by the decreased levels of thyroid hormone are those affecting lipid metabolism. There is a resultant increase in serum cholesterol and triglyceride levels and an increase in arteriosclerosis and coronary artery disease in clients with hypothyroidism. As part of the care plan to meet the needs of a client with mild hypothyroidism, the nurse would C The hypothyroidism client is hypothermic because of subnormal metabolism and needs a warmer environment for comfort. The client is also constipated, has little energy, and has dry skin and hair. In a newly admitted client with thyrotoxicosis, the nurse would plan to address the clinical manifestation of D Thyroid storm is a potentially fatal, acute episode of thyroid overactivity characterized by high fever, severe tachycardia, delirium, dehydration, and extreme irritability. In the initial treatment of a teenager with hyperthyroidism, the nurse would anticipate using C Antithyroid therapy is recommended for hyperthyroid clients under 18 years of age and pregnant women. The major medications used to control hyperthyroidism include thioureas, propylthiouracil, and methimazole. In a client with Graves' disease receiving radioiodine, the nurse would monitor for the common treatment complication of A Because radioiodine destroys thyroid cells, a major complication of 131I therapy is potential hypothyroidism. A nurse assessing a client finds a thyroid nodule that is hard, irregular, and painless. The nurse should suspect D Clinical manifestations of thyroid cancers are a rapidly enlarging hard, irregular, painless nodule in an enlarged thyroid gland. A client just returned from surgery for a thyroid disorder and complains that his/her mouth has an odd sensation. Which medication should the nurse anticipate administering? A Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed during surgery. Manifestations may develop 1 to 7 days after surgery. If the client develops positive Chvostek's or Trousseau's sign, numbness and tingling around the mouth or in the fingertips or toes, muscle spasms, or twitching, the nurse should call the physician immediately and anticipate giving calcium gluconate. The nurse should ensure that calcium gluconate ampules are available at the bedside and the client has a patent intravenous line. In making emergency equipment
available at the bedside of a client who has undergone subtotal thyroidectomy, the nurse would include B The nurse should assemble the equipment at the bedside before the client returns from surgery. The equipment includes a blood pressure cuff and stethoscope, additional pillows, oxygen, suction equipment, intubation supplies, and a tracheostomy set. The nurse caring for a client after a thyroidectomy plans care understanding that which of the following nursing diagnoses takes priority? D Although uncommon, there is a real risk of respiratory obstruction related to swelling at the surgical site or postoperative bleeding. Although all options are valid diagnoses, the airway diagnosis takes priority, particularly in the immediate postoperative period. The nursing diagnosis Impaired Urinary Elimination has been assigned to the client with hyperparathyroidism. To address this diagnosis, the nurse would B The client should take in at least 3000 ml of fluid a day. Dehydration is dangerous for clients with hyperparathyroidism because it both increases the serum calcium level and promotes the formation of renal stones. The nurse caring for a client with hyperparathyroidism should assign priority to D The client with hyperparathyroidism is at great risk for injury, leading to the nursing diagnosis Risk for Injury related to demineralization of bones resulting in pathologic fractures. In a client with hyperthyroidism, the nurse would expect to see C Weight loss occurs as a result of quickened metabolism in hyperthyroid clients. Manifestations include loose bowel movements, heat intolerance, profuse diaphoresis, tachycardia, and incoordination caused by tremor. The skin becomes warm, smooth, and moist because of accelerated circulation to the tissues. Hair appears thin and soft. Self-care measures the nurse should teach a client with
hypoparathyroidism include eating a A The client with hypoparathyroidism should be on a diet high in calcium but low in phosphorus. To aid in immobilizing the head of a client after thyroidectomy, the nurse would obtain D The nurse should support the client's head and neck with pillows and sandbags after thyroidectomy. What foods prevent goiter?Dairy products like yogurt, ice cream, and milk contain iodine. The thyroid needs iodine to prevent its glands from becoming enlarged--known as goiter. Treat yourself to a low-fat serving of frozen yogurt to get sufficient levels of iodine. Eggs contain healthy amounts of both selenium and iodine.
How can goiter be prevented?How can I prevent goiter? A goiter caused by iodine deficiency (simple goiter) is generally the only type of goiter you can prevent. Consuming a diet that includes fish, dairy and a healthy amount of iodized table salt prevents these types of goiters.
What is goiter and how is it prevented?So, a goiter can be a sign the thyroid is not able to make enough thyroid hormone. The use of iodized salt in the United States prevents a lack of iodine in the diet. Other causes of goiter include: The body's immune system attacking the thyroid gland (autoimmune problem) Certain medicines (lithium, amiodarone)
What is the best treatment for goiter?The most commonly used drug, methimazole (Tapazole), may also reduce the size of the goiter. For blocking hormone activities. Your health care provider may prescribe a drug called a beta blocker for managing symptoms of hyperthyroidism.
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The nurse counseling a client in the prevention of goiter would suggest an increased intake of
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