Unit 12 - Class Actvities Flashcards
A 34 year old female is diagnosed with hypothyroidism. Which signs and symptoms would the nurse expect to assess?( Select all that apply)
A.Rapid pulse B.Decreased energy and faigue C.Weight gain of 10 lbs. D.Fine, oily hair E. Consipaion
B.Decreased energy and faigue
C.Weight gain of 10 lbs.
E. Consipaion
The most appropriate diet for the client with Grave's disease would be: A.sof B.high calorie C.low sodium D.high roughage
B.high calorie
A client with hyperthyroidism says to the nurse, “I am so irritable. I am having problems at work because I lose my temper very easily, “ Which of the following responses by the nurse would give the client the most accurate explanation of her behavior.
- “Your behavior is caused by temporary confusion brought on by your illness.”
- “Your behavior is caused by the excess thyroid hormone in your system.”
- “Your behavior is caused by your worrying about the seriousness of your illness.”
- “Your behavior is caused by the stress of trying to manage a career and cope with illness.
- “Your behavior is caused by the excess thyroid hormone in your system.”
* a typical sign of hyperthyroidism is irritability caused by the high levels of circulating thyroid hormones in the body . This symptom decreases as the client responds to therapy. Thyrotoxicosis does not cause confusion. The client may be worried about her illness, and stress may influence her mood; however, irritability is a common symptom of thyrotocxicosis and the client should be informed of that fact rather than blamed
A client with Graves’ disease is treated with radioactive iodine (RAI) in the form of sodium iodide. Which of the following statements by the nurse will explain to the client how the drug works?
- “The radioactive iodine stabilizes the thyroid hormone levels before thyroidectomy.”
- “The radioactive iodine reduces uptake of thyroxine and thereby improves your condition.”
- The radio active iodine lowers the levels of thyroid hormones by slowing your body’s production of them.”
- The radio active iodine destroys thyroid tissue so that thyroid hormones are no longer produced
- The radio active iodine destroys thyroid tissue so that thyroid hormones are no longer produced
* : Radioactive Sodium iodide. Destroys the thyroid follicular cells, and thyroid hormones are no longer produced. RAI is commonly recommended for clients with Graves disease especially the elderly/ and Hyperthyroidism in general. The treatment result is a “medical “ thyroidectomy. RAI is given in lieu of surgery, not before surgery. RAI does not reduce uptake of thyroxine. The outcome of giving RAI is the destruction of the thyroid follicular cells. It is possible to slow the production of thyroid hormones with RAI
The nurse counseling a client in the prevention of goiter in Hypothyroidism would suggest an increased intake of
A. calcium
B. iodine
C. potassium
D. protein
A. calcium
B. iodine
Overstimulation of sympathetic nervous system: eye muscles enlarge/ they do NOT decrease when condition corrected
Hyperthyroidism Exophthalmia:
Julia Perez a 35 year old female is admitted to a medical surgical unit with Graves disease. Which of the following signs would the nurse expect to see upon admission?
a. Weight gain, cold intolerance
b. Slow heart rate; rash
c. Skin hot and moist, rapid heart rate
d. Constipation, confusion
c. Skin hot and moist, rapid heart rate
The nurse is caring for a client following a thyroidectomy and is monitoring for signs of thyroid storm. Which of the following symptoms indicate this condition.
a. low grade fever
b. bradycardia
c. Hypotension
d. constipation
a. low grade fever
The Basal metabolic rate is unusually \_\_\_\_ with hypothyroidism. A. High B. Low C. Steady D. Variable
B. Low
Situation: Andrea Pitt’s mother, Mary Vanderbush, was brought to the emergency department. Ms. Pitt found her mother at home unresponsive. Her pulse was very slow and her skin was cool and dry. She had been increasingly depressed and confused over the last six to eight months. She suffered a heart attack about two years ago, but seemed to recover well. The physician had lab tests done, and made a tentative diagnosis of myxedema coma. She was admitted to the medical intensive care unit.
The physician plans to return Ms. Vanderbush to a normal thyroid state very gradually. What is the risk of a too rapid restoration to normal thyroid hormone levels?
a. Serum electrolytes may be restored to normal too quickly, resulting in cerebral edema.
b. Renal function may not be able to keep up with the increased need for fluid excretion as the edema resolves.
c. If improved thyroid status causes a too rapid increase in demands for oxygen by the peripheral tissues, her compromised coronary circulation may be inadequate, causing another myocardial infarction.
d. Too rapid a correction of her altered mental status may result in agitation and combative behavior.
c. If improved thyroid status causes a too rapid increase in demands for oxygen by the peripheral tissues, her compromised coronary circulation may be inadequate, causing another myocardial infarction.
Same Case Study:
Ms. Vanderbush’s physician prescribed a broad spectrum IV antibiotic. The most likely reason for this medication is that
a. she is at great risk for aspiration and a subsequent chemical pneumonia.
b. she now has an indwelling Foley catheter, and is at risk for urinary tract infections.
c. many patients in myxedema coma have an infection as the stressor that precipitated the coma.
d. she is in an area of the hospital where iatrogenic infections are a common problem.
c. many patients in myxedema coma have an infection as the stressor that precipitated the coma.
The nurse is completing a health assessment of a 42 year old female with suspected Graves disease. The nurse should assess the client for:
a. Anorexia
b. Tachycardia
c. Weight gain
d. Cold skin
b. Tachycardia (graves is a hypermetabolic state)
* All the other conditions are symptoms of hypothyroidism
DANGER with removal of thyroid gland/damage parathyroid gland
laryngeal spasms due to low calcium /NO airway!/ have Calcium gluconate ready to give IV
*Chvostek Sign = hypocalcemia
Secretes catecholamine’s of epinephrine and norepinephrine.
adrenal medulla
pheochromocytoma: cause severe HTN / sporadic: Present with diaphoresis Headache palpitation and HTN
tumor on adrenal medulla = can be life-threatening
