Thyroid Disorders HESI Case Study

question

Which disease is the most common type of hyperthyroidism?
answer

Graves disease
question

Which factor in Ms. Pool’s hx places her at risk for a thyroid problem?
answer

Her age and gender
question

Which term should the nurse use when documenting Ms. Pool’s wide-eyed appearance?
answer

Exopthalamos
question

What additional clinical manifestations is Ms. Pool likely to exhibit?
answer

Tachycardia and palpitations Diarrhea and weight loss Anxiety and fatigue
question

Which information in a client’s hx represents a contraindication to the use of radioactive iodine (RAI)?
answer

Shellfish allergy
question

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?
answer

Advise the client that antidepressant use will not affect the thyroid scan.
question

How should the nurse describe the action of propranolol (Inderal) to Ms. Pool?
answer

Reduces symptoms such as palpitations and nervousness.
question

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?
answer

1
question

What instruction should the nurse include when teaching Ms. Pool about the use of PTU (propylthiouracil)?
answer

“Report the onset of a sore throat or fever to the HCP.”
question

Which nursing intervention is appropriate for a client receiving RAI?
answer

Encourage the client to drink plenty of fluids.
question

Before the procedure, the client should be informed of which possible long-term side effect of RAI?
answer

Hypothyroidism
question

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?
answer

Since Ms. Pool is legally competent, she should give her own consent.
question

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?
answer

Oberve neck dressing.
question

Which assessment finding would indicate the possible onset of thyroid storm?
answer

Tachycardia, fever, and altered mental state.
question

What additional assessment technique should the nurse perform to assess for hypocalcemia?
answer

Assess for Cvostek’s sign
question

The additional assessment for hypocalcemia is positive. Which nursing action should be implemented immediately?
answer

Confirm that a tracheostomy set, suction, and O2 are available at bedside.
question

The nurse would expect to administer which medication to treat Ms. Pool’s hypocalcemia?
answer

Calcium gluconate
question

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?
answer

“It sounds like that was a very frightening experience for you.”
question

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?
answer

“You sound very fearful about being able to breath.”
question

What is the best client care assignment for the LPN?
answer

A client with hyperthyroidism scheduled for radiation.
question

Which task should the nurse assign the LPN during this time?
answer

Take and record vital signs on the other three clients.
question

Ms. Pool starts taking an oral dose of 50 mcg of levothyroxine. Which behavior indicates to the nurse that Ms. Pool understands the instructions?
answer

Ms. Pool states that too much medication will cause her to feel like she did before her surgery.
question

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?
answer

Increase her dose of levothyroxine
question

What dx might be included in the plan of care? (Remember, the symptoms of hypothyroidism are the opposite of hyperthyroidism or Graves disease).
answer

Decreased cardiac output

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