Chapter 19 Flashcards

1
Q

The nurse is teaching the patient, newly diagnosed with Gravess disease, about the
normal functioning of the thyroid gland. What hormone will the nurse tell the patient
controls production and release of thyroid hormones?

A

Thyroid-stimulating hormone (TSH)

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2
Q

A child is diagnosed with hypothyroidism. The nurse anticipates an order for the drug of
choice when treating children, which is what?

A

Levothyroxine (Synthroid)

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3
Q

A patient is at risk for thrombosis formation and is taking an oral anticoagulant. The
patient has been newly diagnosed with hypothyroidism and placed on levothyroxine
(Synthroid). What will the nurse monitor the patient for?

A

Increased bruising and bleeding

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4
Q

The nurse is providing patient teaching regarding the administration of levothyroxine
(Synthroid). What is the nurses priority teaching point?

A

Take the medication with a full glass of water.

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5
Q

The nurse instructs the patient with a new prescription to treat hyperthyroidism and
includes the importance of regular lab studies to monitor for bone marrow suppression,
which can be an adverse effect of this drug. What drug is the nurse teaching the patient
about?

A

Methimazole (Tapazole)

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6
Q

A patient is seen in the clinic and diagnosed with hyperthyroidism. Potassium iodide is
prescribed. The nurse reviews the patients medical record before administering the drug.
What assessment finding would cause the nurse to alter the plan of care?

A

Digoxin 0.125 mg daily

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7
Q

A patient with Pagets disease calls the clinic and tells the nurse that she is experiencing
flushing of the face and hands and a rash. The patient states that she is taking calcitonin,
salmon (Calcimar) for her Pagets disease. What is the nurses best response?

A

This is a common adverse effect of your medication that will lessen with time.

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8
Q

The nurse is teaching the patient with a new prescription for ibandronate (Boniva) how to
take the medication. Which instruction provided by the nurse is correct?

A

Take 150 mg once a month on the same day of the month.

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9
Q

The nurse admits an elderly patient in thyroid crisis for whom surgery is not an option.
What antithyroid drug would the nurse expect will be ordered?

A

Propylthiouracil (PTU)

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10
Q

The nurse is providing care for a man diagnosed with osteoporosis. What drug will the
nurse administer that is the only drug approved for treatment in men?

A

Alendronate (Fosamax)

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11
Q

What assessment findings would the nurse expect to see in a patient who overdosed on
levothyroxine (Synthroid)?

A

Nervousness, tachycardia, tremors

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12
Q

After administering propylthiouracil (PTU), what effect would the nurse anticipate the
drug will have in the patients body?

A

To inhibit production of thyroid hormone in the thyroid gland

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13
Q

The nurse provides teaching regarding levothyroxine to a 55-year-old patient diagnosed
with Hashimotos disease. What statement made by the patient does the nurse interpret to
mean that the drug teaching had been understood?

A

I should take this medication on an empty stomach in the morning.

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14
Q

The nurse, developing a care plan for a patient diagnosed with hypothyroidism, creates what appropriate nursing diagnosis?

A

Decreased cardiac output

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15
Q

The nurse is caring for a 5-year-old child diagnosed with hypothyroidism whose mother voices skepticism about giving the child drugs. In explaining the need for medication, what will the nurse tell this mother could result if her daughters condition remains untreated so she can make an informed decision?

A

Mental retardation

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16
Q

A patient is diagnosed with a simple goiter and asks the nurse what caused it. What is the nurses best response?

A

A goiter is the result of too much TSH.

17
Q

The patient with hypothyroidism takes levothyroxine daily and has triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) levels drawn in the laboratory to check appropriateness of prescribed dosage. What results would the nurse analyze as indicating the need for a higher dosage of medication?

A

Elevated TSH, reduced T3 and T4 levels

18
Q

A patient presents at the clinic with complaints of weight loss despite an increased appetite. The nurse assesses this patient for what?

A

Hyperthyroidism

19
Q

What patient will the nurse assess most closely for secondary hyperparathyroidism?

A

The 68-year-old patient with chronic renal failure

20
Q

What drug would the nurse appropriately administer to the patient to treat hypothyroidism?

A

Levothyroxine

21
Q

The nurse is caring for a patient with a history of myocardial infarction and heart failure. What thyroid replacement drug would the nurse question if ordered?

A

Liothyronine

22
Q

The nurse is caring for a patient newly diagnosed with hypothyroidism. The patient also takes theophylline to control asthma symptoms. What changes will need to be made to the
patients theophylline dose?

A

Increase theophylline dosage immediately.

23
Q

The nurse is caring for a 57-year-old woman who is complaining about gaining so much weight after menopause and suggests that thyroid hormone replacement would help her lose weight and speed up her metabolism. What is the nurses best response?

A

The body compensates for the extra hormone by reducing the amount secreted.

24
Q

The patient is 8 weeks pregnant and requires an antithyroid medication. The nurse identifies what drug as the drug of choice for this patient?

A

Propylthiouracil

25
Q

The nurse is discharging a patient with a new prescription for levothyroxine. What would the nurse teach the patient to report to her health care provider? (Select all that apply.)

A

Nervousness
Insomnia
Chest pain

26
Q

The nurse tells the patient his or her serum calcium level is elevated and the patient asks what controls calcium levels in the body. What is the nurses best response?

A

Parathyroid hormone (PTH)

27
Q

The nurse is caring for a patient diagnosed with hyperparathyroidism who asks the nurse
why parathyroid hormone (PTH) is important. The nurse explains that PTH performs what actions in the body? (Select all that apply.)

A

Stimulation of osteoclasts
Increased intestinal absorption of calcium
Stimulation of calcitriol production

28
Q

The nurse is teaching the patient how to take his newly prescribed alendronate and includes what teaching points? (Select all that apply.)

A

Take the drug in the morning
Take the drug with a full glass of water
Remain upright for 30 minutes after taking the medication

29
Q

The nurse is caring for an asthmatic patient prescribed zoledronic acid. What important question should the nurse ask this patient?

A

Can you take aspirin without experiencing any bad effects?

30
Q

The nurse is caring for a pediatric patient with hypercalcemia. What condition would the nurse suspect is causing this altered serum calcium level?

A

Malignancy

31
Q

The nurse is caring for a patient who takes alendronate. What lab studies would the nurse assess regularly?

A

Serum calcium

32
Q

The patient, newly prescribed cinacalcet hydrochloride (Sensipar), asks the nurse how this drug works. What is the nurses best response?

A

It promotes entry of calcium into bone.