Chapter 49 PT2

START FROM QUIZLET QUESTION 61

Chapter 49 PT2

54問 • 1年前START FROM QUIZLET QUESTION 61

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A patient has been admitted to an acute care hospital with a diagnosis of hypoparathyroidism. Which finding would the nurse most likely elicit upon assisting with data collection on the patient?

Twitching of facial muscles

Medication used to treat a patient with hypoparathyroidism has been prescribed by the health care provider. Which medications would the nurse expect to find in the patient's chart?

Calcium salts

Several hours after a thyroidectomy, a patient is transferred from a stretcher to a bed. Which position would the nurse place the patient in after checking the bandage?

Semi-Fowler

A patient with a history of hyperthyroidism returns to the unit 12 hours after a thyroidectomy. The nurse notes tachycardia, cardiac dysrhythmias, vomiting, and fever. Which diagnosis does the nurse suspect the patient is experiencing based on these findings?

thyroid storm

A patient scheduled for a partial thyroidectomy asks the nurse why they are being given an iodine preparation before surgery. Which response by the nurse is the best response?

It will decrease the release of thyroid hormones before surgery."

Which priority intervention should be implemented when 12 hours after a total thyroidectomy, the patient develops dyspnea and respiratory distress?

Prepare for an emergency tracheotomy.

Which priority intervention will the nurse implement when on the second postoperative day after a subtotal thyroidectomy, the patient tells the nurse that they feel numbness and tingling around their mouth?

Attempt to elicit Chvostek sign.

Which statement by the patient indicates understanding of teaching regarding propylthiouracil (PTU)? (Select all that apply.)

"I will seek medical attention if I develop a sore throat.", Liver problems can occur with this drug, so I need to report jaundice., If I become pregnant, I need to notify my health care provider immediately."

Which classification of drugs could precipitate a potentially fatal myxedema (hypothyroidism) coma in a person with severe hypothyroidism? (Select all that apply.)

Opioids, Sedatives, Tranquilizers

Which response is best after a patient with hypothyroidism asks what measures will help with constipation? (Select all that apply.)

Add fiber to the diet., Ensure adequate fluid intake, Age-appropriate physical activity will help.

Which statement by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

"I feel a lump in my throat when I swallow."

Which question from a nurse during a patient interview will provide focused information about a possible thyroid disorder?

"Have you had a recent unplanned weight gain or loss?"

A 61-yr-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels.

parathyroid hormone

During the nurse's physical examination of a young adult, the patient's thyroid gland cannot be felt. The most appropriate action by the nurse is to

document that the thyroid was nonpalpable.

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

Thyroid-stimulating hormone (TSH) level

A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?

Ionized calcium

A registered nurse (RN) is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching?

The RN palpates the neck to assess thyroid size.

When assessing a new patient at the outpatient clinic, the nurse notes dry, scaly skin; thin hair; and thick, brittle nails. What is the nurse's most important action?

Consult with the health care provider about the need for further diagnostic testing.

A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient

that symptoms of hypothyroidism may occur as the RAI therapy takes effect.

A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to occur in 2 days. Which teaching strategy is likely to result in effective patient self-management at home?

Provide written reminders of information taught.

Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before ad- ministering levothyroxine (Synthroid)?

Increased thyrox- ine (T4) level

Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease?

Antithyroid medications may take sev- eral months for full effect.

A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse anticipate next?

Administer IV calcium gluconate.

Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos?

Elevate the head of the patient's bed to reduce periorbital fluid.

A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L). Which nursing action should be included in the plan of care?

Encourage 4000 mL of fluids daily.

A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid relief from the symptoms?

Have the patient rebreathe from a paper bag.

A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. The nurse should plan to teach the patient about

calcium supplements to normalize serum calcium levels.

A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?

Assess the patient's respiratory effort.

Which prescribed medication should the nurse expect will have rapid effects on a patient admitted to the emergency department in thyroid storm?

Propranolol (Inderal)

Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse?

Temperature 103.8° F (40.4° C)

A 37-yr-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon?

Increasing neck swelling.

After receiving change-of-shift report about the fol- lowing four patients, which patient should the nurse assess first?

A 70-yr-old fe- male patient taking levothyroxine (Synthroid) who has an irregular pulse of 134

Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter?

"What medications are you taking?"

Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?

New-onset changes in the patient's voice

The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring. Which patient should be transferred to the cardiac unit first?

Patient with tetany who has a new order for IV calcium chloride

Following a thyroidectomy, a patient complains of "a tingling feeling around my mouth." Which assessment should the nurse complete?

Presence of the Chvostek's sign

Which assessment finding alerts the nurse to provide patient teaching about cataract development?

History of hyperthyroidism

Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease?

Antithyroid medications may take several months for full effect.

A patient, newly diagnosed with hypothyroidism, is anxious to begin her drug regimen. Which information should the nurse's instructions relative to hormone replacement include?

"Know the signs and symptoms of hyperthyroidism."

Which patient recommendation should a nurse include when preparing to present presurgical teaching of a patient scheduled for a subtotal thyroidectomy?

Demonstrate how to deep breathe and support her head during position changes.

A nurse assesses a client with hyperthyroidism who is prescribed lithium carbonate. Which assessment finding should alert the nurse to a side effect of this therapy?

increased thirst and urination

A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor. Which action should the nurse take first?

Contact the provider and prepare for intubation.

A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the second postoperative day the client states, I feel numbness and tingling around my mouth. What action should the nurse take?

Assess for Chvostek's sign.

A nurse assesses a client on the medical-surgical unit.Which statement made by the client should alert the nurse to the possibility of hypothyroidism?

"I am always tired, even with 12 hours of sleep."

A nurse cares for a client who presents with brady- cardia secondary to hypothyroidism. Which medication should the nurse anticipate being prescribed to the client?

evothyroxine sodium (Synthroid)

A nurse plans care for a client with hypothyroidism. Which priority problem should the nurse plan to address first for this client?

Depression and withdrawal

A nurse assesses a client who is prescribed levothyroxine (Synthroid) for hypothyroidism. Which assessment finding should alert the nurse that the medication therapy is effective?

Heart rate is 70 bpm and regular.

A nurse cares for a client who has hypothyroidism as a result of Hashimotos thyroiditis.The client asks, How long will I need to take this thyroid medication? How should the nurse respond?

"You'll need thyroid pills for life because your thyroid won't start working again."

A nurse assesses clients for potential endocrine dis- orders. Which client is at greatest risk for hyperparathyroidism?

A 41-year-old male receiving dialysis for end-stage kidney disease

A nurse plans care for a client with hyperparathyroidism. Which intervention should the nurse include in this clients plan of care?

Use a lift sheet to assist the client with position changes.

A nurse cares for a client who is recovering from a parathyroidectomy. When taking the clients blood pressure, the nurse notes that the clients hand has gone into flexion contractions. Which laboratory result does the nurse correlate with this condition?

Serum calcium: 6.9 mg/dL

A nurse cares for a client newly diagnosed with Graves disease. The clients mother asks, I have diabetes mellitus. Am I responsible for my daughters disease? How should the nurse respond?

"An association has been noted between Graves' disease and diabetes, but the fact that you have diabetes did not cause your daughter to have Graves' disease."

While assessing a client with Graves disease, the nurse notes that the clients temperature has risen 1 F. Which action should the nurse take first?

Turn the lights down and shut the clients door.

After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional instruction?

"After surgery, I won't need to take thyroid medication."

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