Thyroid Disorders HESI Case Study – Flashcards
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Which disease is the most common type of hyperthyroidism?
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Graves disease
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Which factor in Ms. Pool's hx places her at risk for a thyroid problem?
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Her age and gender
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Which term should the nurse use when documenting Ms. Pool's wide-eyed appearance?
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Exopthalamos
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What additional clinical manifestations is Ms. Pool likely to exhibit?
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Tachycardia and palpitations Diarrhea and weight loss Anxiety and fatigue
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Which information in a client's hx represents a contraindication to the use of radioactive iodine (RAI)?
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Shellfish allergy
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Ms. Pool reports to the nurse that she took an antidepressant for several months, but is no longer taking the med. Which intervention should the nurse implement prior to the thyroid scan?
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Advise the client that antidepressant use will not affect the thyroid scan.
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How should the nurse describe the action of propranolol (Inderal) to Ms. Pool?
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Reduces symptoms such as palpitations and nervousness.
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The liquid medication prescribed comes in a solution of 4 mg/mL. How many teaspoons of the medication will the nurse instruct her to take for each dose of 20 mg?
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1
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What instruction should the nurse include when teaching Ms. Pool about the use of PTU (propylthiouracil)?
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"Report the onset of a sore throat or fever to the HCP."
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Which nursing intervention is appropriate for a client receiving RAI?
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Encourage the client to drink plenty of fluids.
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Before the procedure, the client should be informed of which possible long-term side effect of RAI?
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Hypothyroidism
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Ms. Pool is asleep, the nurse considers calling her mother and asks her to give consent over the telephone for surgery. Which statement is accurate concerning this situation?
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Since Ms. Pool is legally competent, she should give her own consent.
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Ms. Pool returns to the unit, drowsy but arousable, VSS, breath sounds clear bilat, incisional pain 4/10. Which assessment is most important for the nurse to complete next?
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Oberve neck dressing.
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Which assessment finding would indicate the possible onset of thyroid storm?
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Tachycardia, fever, and altered mental state.
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What additional assessment technique should the nurse perform to assess for hypocalcemia?
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Assess for Cvostek's sign
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The additional assessment for hypocalcemia is positive. Which nursing action should be implemented immediately?
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Confirm that a tracheostomy set, suction, and O2 are available at bedside.
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The nurse would expect to administer which medication to treat Ms. Pool's hypocalcemia?
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Calcium gluconate
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She state, "What is this happens again? I stay awake at night afraide I won't be able to breathe again." What is the best response by the nurse?
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"It sounds like that was a very frightening experience for you."
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She goes on to say, "My father died of emphysema d/t smoking. It was hard to watch him stuggle to breathe day after day." Which response by the nurse would be the most therapeutic?
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"You sound very fearful about being able to breath."
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What is the best client care assignment for the LPN?
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A client with hyperthyroidism scheduled for radiation.
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Which task should the nurse assign the LPN during this time?
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Take and record vital signs on the other three clients.
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Ms. Pool starts taking an oral dose of 50 mcg of levothyroxine. Which behavior indicates to the nurse that Ms. Pool understands the instructions?
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Ms. Pool states that too much medication will cause her to feel like she did before her surgery.
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She c/o fatigue, increasing constipation, and weight gain. Her serum TSH level is elevated. Based on the clinical manifestations and lab results, what change in medication should the nurse anticipate?
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Increase her dose of levothyroxine
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What dx might be included in the plan of care? (Remember, the symptoms of hypothyroidism are the opposite of hyperthyroidism or Graves disease).
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Decreased cardiac output
