Medsurg Final 2

Question 1

most common cause of hyperthyroidism

Answer 1

Graves’ disease

Question 2

Graves’ disease is the most common cause of

Answer 2

hyperthyroidism

Question 3

____ hyperthyroidism is caused by excessive dosages of thyroid hormone.

Answer 3

Exogenous

Question 4

hyperthyroidism findings in older adult clients are often more ___ than those in younger clients.

Answer 4

subtle

Question 5

Older adult clients who have hyperthyroidism often present with heart failure and ___ ___

Answer 5

atrial fibrillation

Question 6

Testing for hyperthyroid: Recent use of ____ media and client’s use of ___ ____ may cause falsely elevated serum thyroid hormone levels

Answer 6

Contrast media and oral contraceptives

Question 7

Severe illness; malnutrition; and the use of aspirin, corticosteroids, and phenytoin sodium may cause

Answer 7

a false decrease in serum thyroid hormone levels.

Question 8

Testing for hyperthyroid: Inform the provider if the client received any ___ ___ within 4 weeks of the test.

Answer 8

iodine contrast

Question 9

hyperthyroid: Minimize the client’s

Answer 9

energy expenditure (they wear out easy)

Question 10

hyperthyroid: Report a temperature

Answer 10

increase of 1 degree or more to the provider immediately.

Question 11

hyperthyroid: Assure the family that any abrupt changes in the client’s behavior are likely disease related and

Answer 11

should subside with antithyroid therapy.

Question 12

Thionamides – methimazole (Tapazole) and propylthiouracil (PTU) inhibit

Answer 12

the production of thyroid hormone.

Question 13

used to treat Graves’ disease, as an adjunct to radioactive iodine therapy

Answer 13

Thionamides

Question 14

hyperthyroid tx: Remind the client that thionamides typically are taken for

Answer 14

1 to 2 years

Question 15

hyperthyroid: Treat sympathetic nervous system effects (tachycardia, palpitations) with

Answer 15

beta blocker

Question 16

Which hyperthyroid med: Teach the client to check pulse prior to each dose

Answer 16

beta blocker

Question 17

SSKI is used to treat

Answer 17

hyperthyroid

Question 18

Lugol’s solution and SSKI: administer

Answer 18

1 hr after an antithyroid medication

Question 19

Use of Lugol’s solution and SSKI is contraindicated in

Answer 19

pregnancy

Question 20

Which hyperthyroid med: Advise the client that the effects of therapy may not be evident for 6 to 8 weeks

Answer 20

radio iodine 131

Question 21

Take a laxative 2 to 3 days after treatment to help rid the body of stool contaminated with

Answer 21

radiation

Question 22

Do not use same toilet as others for 2 weeks, sit down to urinate, and flush toilet three times.

Answer 22

radiation

Question 23

thyroidectomy: The client should receive ____ for 10 to 14 days before surgery. This reduces the gland’s size and prevents excess bleeding.

Answer 23

iodine

Question 24

thyroidectomy: The client should receive iodine for 10 to 14 days before surgery. This

Answer 24

reduces the gland’s size and prevents excess bleeding.

Question 25

thyroidectomy Postprocedure: Check for laryngeal nerve damage by

Answer 25

asking the client to speak as soon as awake from anesthesia

Question 26

thyroidectomy: ___ and ___ can occur if parathyroid glands are damaged or removed

Answer 26

Hypocalcemia and tetany

Question 27

thyroidectomy: Advise the client that the voice will become hoarse, and to expect

Answer 27

pain

Question 28

Instruct clients who have had a total thyroidectomy they will have to take thyroid replacement medications for

Answer 28

ever

Question 29

thyroidectomy: ____ reduce postoperative edema

Answer 29

Corticosteroids

Question 30

thyroidectomy: with Corticosteroids tx, provide ____ to reduce swelling.

Answer 30

humidity

Question 31

Thyroid Storm/Crisis: Administer _____ to treat shock.

Answer 31

glucocorticoids

Question 32

Thyroid Storm/Crisis: Caution – If given before PTU, ___ ___ can exacerbate manifestations in susceptible clients.

Answer 32

sodium iodide

Question 33

In tx of hyperthyroid, there’s a risk for Hypocalcemia and Tetany. Have IV ___ ___ available for emergency administration

Answer 33

calcium gluconate

Question 34

Secondary hypothyroidism is caused by failure of the

Answer 34

anterior pituitary gland to stimulate the thyroid gland or failure of the target tissues to respond to the thyroid hormones

Question 35

Tertiary hypothyroidism is caused by failure of the hypothalamus to

Answer 35

produce thyroid-releasing factor.

Question 36

a state of severe hypothyroidism found in infants

Answer 36

Cretinism

Question 37

Cretinism results in retardation of

Answer 37

cognitive development, physical growth, or both

Question 38

most often caused by chronic autoimmune thyroiditis and affects the growth and sexual maturation of the child

Answer 38

Juvenile hypothyroidism

Question 39

hypothyroidism is often undiagnosed in older adult clients because

Answer 39

it may mimic the normal aging process

Question 40

2 meds that may cause hypothyroid

Answer 40

lithium

amiodarone

Question 41

Radioisotope (123I) scan: Clients who have hypothyroidism have a

Answer 41

low uptake of the iodine preparation

Question 42

hypothyroidism ECG

Answer 42

flat or inverted T waves, and ST deviations

Question 43

hypothyroidism diet

Answer 43

low-calorie, high-bulk

Question 44

hypothyroidism: Avoid fiber laxatives, which interfere with absorption of

Answer 44

levothyroxine

Question 45

hypothyroidism: Avoid ___ laxatives, which interfere with absorption of levothyroxine

Answer 45

fiber

Question 46

hypothyroidism: client is cold, Caution the client against using

Answer 46

electric blankets

Question 47

hypothyroidism: drugs that are avoided because of the risk of respiratory depression.

Answer 47

CNS depressants (barbiturates or sedatives)

Question 48

hypothyroidism: If CNS depressants are prescribed,

Answer 48

the dose should be significantly lower

Question 49

hypothyroidism: treatment of choice.

Answer 49

Thyroid hormone replacement therapy

Question 50

hypothyroidism: Thyroid hormone replacement therapy drug

Answer 50

levothyroxine

Question 51

hypothyroidism: Thyroid hormone replacement therapy increases the effects of

Answer 51

warfarin

Question 52

hypothyroidism: Thyroid hormone replacement therapy can increase the need for ___ and ___

Answer 52

insulin and digoxin

Question 53

hypothyroidism: Use caution when starting thyroid hormone replacement with __ ___ clients and those who have ___

Answer 53

older adult

CAD

Question 54

hypothyroidism: What is the main system you’re concerned about with hormone replacement therapy

Answer 54

cardiac

Question 55

hypothyroidism: Thyroid hormone replacement therapy: Instruct the client that treatment begins

Answer 55

slowly

Question 56

hypothyroidism: Inform the client that fiber supplements, calcium, iron, and antacids interfere with absorption.

Answer 56

Thyroid hormone replacement therapy (levothyroxine)

Question 57

hypothyroidism: Thyroid hormone replacement therapy will last for

Answer 57

always

Question 58

life-threatening condition that occurs when hypothyroidism is untreated or when a stressor (such as infection, heart failure, stroke, or surgery) affects an individual who has hypothyroidism

Answer 58

Myxedema coma

Question 59

at risk for Myxedema

Answer 59

Clients who have been taking levothyroxine and suddenly stop the medication

Question 60

Myxedema coma pharma tx

Answer 60

large doses of levothyroxine via IV bolus

Question 61

Myxedema tx: urine output should

Answer 61

increase (makes sense bc you’re reversing hypo symptoms)

Question 62

Myxedema: treat hypoglycemia with

Answer 62

glucose