Podcast
Questions and Answers
A patient is scheduled for diagnostic tests for hypothyroidism. Which finding will the nurse anticipate when caring for this patient?
A patient is scheduled for diagnostic tests for hypothyroidism. Which finding will the nurse anticipate when caring for this patient?
The nurse is monitoring a patient admitted for testing for diabetes insipidus. What actions should the nurse take when providing care?
The nurse is monitoring a patient admitted for testing for diabetes insipidus. What actions should the nurse take when providing care?
A patient who is 1-day postoperative thyroidectomy reports feeling numb around the mouth and is experiencing random muscle twitches. Which IV medication does the nurse anticipate being prescribed by the health-care provider(HCP)
A patient who is 1-day postoperative thyroidectomy reports feeling numb around the mouth and is experiencing random muscle twitches. Which IV medication does the nurse anticipate being prescribed by the health-care provider(HCP)
The nurse is providing care for a patient with syndrome of inappropriate antidiuretic hormone(SIADH). Which additional diagnosis does the nurse need to identify as a contributor to the patient's disorder?
The nurse is providing care for a patient with syndrome of inappropriate antidiuretic hormone(SIADH). Which additional diagnosis does the nurse need to identify as a contributor to the patient's disorder?
Signup and view all the answers
The nurse is monitoring a patient 6 hours after a thyroidectomy for cancer. Vital signs are 104F(40C), pulse 144 beats/minute, respirations 24/minute, and BP 184/108 mmHg. Which prescription does the nurse anticipate from the HCP?
The nurse is monitoring a patient 6 hours after a thyroidectomy for cancer. Vital signs are 104F(40C), pulse 144 beats/minute, respirations 24/minute, and BP 184/108 mmHg. Which prescription does the nurse anticipate from the HCP?
Signup and view all the answers
The nurse is gathering information from a patient in a HCP's office. The patient reports difficulty speaking and swallowing, and frequent headaches. What diagnostic test is anticipated in addition to a computed tomography(CT)scan of the head?
The nurse is gathering information from a patient in a HCP's office. The patient reports difficulty speaking and swallowing, and frequent headaches. What diagnostic test is anticipated in addition to a computed tomography(CT)scan of the head?
Signup and view all the answers
The nurse is contributing to the plan of care for an adult patient diagnosed with GH deficiency. Which nursing intervention is appropriate for this patient?
The nurse is contributing to the plan of care for an adult patient diagnosed with GH deficiency. Which nursing intervention is appropriate for this patient?
Signup and view all the answers
The nurse determines that treatment has been effective for a patient with diabetes insipidus. Which laboratory value is consistent with this conclusion?
The nurse determines that treatment has been effective for a patient with diabetes insipidus. Which laboratory value is consistent with this conclusion?
Signup and view all the answers
The nurse is providing care for a patient who is postoperative for a transsphenoidal surgery for the removal of a pituitary tumor. Which nursing care is appropriate in the postsurgical period?
The nurse is providing care for a patient who is postoperative for a transsphenoidal surgery for the removal of a pituitary tumor. Which nursing care is appropriate in the postsurgical period?
Signup and view all the answers
A patient with a history of hypothyroidism arrives a t the emergency department and states, “I was outside shoveling snow and suddenly started to feel short of breath and like I couldn't think straight.” What concern does the nurse have
A patient with a history of hypothyroidism arrives a t the emergency department and states, “I was outside shoveling snow and suddenly started to feel short of breath and like I couldn't think straight.” What concern does the nurse have
Signup and view all the answers
A patient enters the emergency department in adrenal crisis. The patient is lethargic and vital signs are BP 85/52 mm Hg and pulse 88 beats/minute. Which event in the patient's week most likely precipitated this crisis?
A patient enters the emergency department in adrenal crisis. The patient is lethargic and vital signs are BP 85/52 mm Hg and pulse 88 beats/minute. Which event in the patient's week most likely precipitated this crisis?
Signup and view all the answers
The nurse is reinforcing teaching to a patient who is diagnosed with hypoparathyroidism. Which comment by the patient indicates that patient teaching is successful？
The nurse is reinforcing teaching to a patient who is diagnosed with hypoparathyroidism. Which comment by the patient indicates that patient teaching is successful？
Signup and view all the answers
The licensed practical nurse/licensed vocational nurse(LPN/LVN)is assisting in the care of a 51-year-old patient recovering from a hypophysectomy. Which finding should be reported to the registered nurse(RN) or HCP?
The licensed practical nurse/licensed vocational nurse(LPN/LVN)is assisting in the care of a 51-year-old patient recovering from a hypophysectomy. Which finding should be reported to the registered nurse(RN) or HCP?
Signup and view all the answers
The nurse is caring for a patient who's had a 10% weight loss since being diagnosed with hyperthyroidism. What action should the nurse take?
The nurse is caring for a patient who's had a 10% weight loss since being diagnosed with hyperthyroidism. What action should the nurse take?
Signup and view all the answers
The LPN/LVN is monitoring a patient with a goiter who is scheduled for surgery. Physical inspection reveals only slight swelling in the anterior base of the neck. Which finding will prompt the LVN/LPN to notify the RN?
The LPN/LVN is monitoring a patient with a goiter who is scheduled for surgery. Physical inspection reveals only slight swelling in the anterior base of the neck. Which finding will prompt the LVN/LPN to notify the RN?
Signup and view all the answers
The nurse is assigned to provide care for a patient diagnosed with diabetes insipidus. While reviewing the nursing care planned for the patient, Which intervention will the nurse recognize a s being most important?
The nurse is assigned to provide care for a patient diagnosed with diabetes insipidus. While reviewing the nursing care planned for the patient, Which intervention will the nurse recognize a s being most important?
Signup and view all the answers
The nurse is monitoring the effects of a water deprivation test on a patient suspected of diabetes insipidus related to pituitary dysfunction. Which test result supports the diagnosis
The nurse is monitoring the effects of a water deprivation test on a patient suspected of diabetes insipidus related to pituitary dysfunction. Which test result supports the diagnosis
Signup and view all the answers
The nurse is providing care for a patient diagnosed with Cushing syndrome. What should the nurse include in the care
The nurse is providing care for a patient diagnosed with Cushing syndrome. What should the nurse include in the care
Signup and view all the answers
The nurse is gathering data from a patient who voices concerns about feeling dizzy upon standing fatigue , and recent weight loss. What additional finding supports adrenal insufficiency？
The nurse is gathering data from a patient who voices concerns about feeling dizzy upon standing fatigue , and recent weight loss. What additional finding supports adrenal insufficiency？
Signup and view all the answers
The nurse is caring for a patient who comes to the clinic with severe hypertension, tachycardia, palpitations, diaphoresis, and feelings of apprehension. What question should the nurse ask?
The nurse is caring for a patient who comes to the clinic with severe hypertension, tachycardia, palpitations, diaphoresis, and feelings of apprehension. What question should the nurse ask?
Signup and view all the answers
The nurse is attending to patients in an assisted-living facility. What symptoms should the nurse monitor for when concerned about hyperthyroidism?
The nurse is attending to patients in an assisted-living facility. What symptoms should the nurse monitor for when concerned about hyperthyroidism?
Signup and view all the answers
The nurse is assisting with discharge of a patient with Addison disease following and adrenal crisis. Which instruction is most important for the nurse to reinforce
The nurse is assisting with discharge of a patient with Addison disease following and adrenal crisis. Which instruction is most important for the nurse to reinforce
Signup and view all the answers
A patient is being discharged with prescribed treatment for long-term hypoparathyroidism. Which does the nurse include in discharge teaching(select all the apply)
A patient is being discharged with prescribed treatment for long-term hypoparathyroidism. Which does the nurse include in discharge teaching(select all the apply)
Signup and view all the answers
A patient with suspected hyperthyroidism is scheduled for a radioactive iodine uptake test. Which symptoms of hyperthyroidism does the nurse note on the medical record?(Select all that apply.)
A patient with suspected hyperthyroidism is scheduled for a radioactive iodine uptake test. Which symptoms of hyperthyroidism does the nurse note on the medical record?(Select all that apply.)
Signup and view all the answers
A patient diagnosed with SIADH is scheduled for surgery in a few days. Which does the nurse expect to be prescribed for this patient to help manage the symptoms until surgery?(Select all that apply)
A patient diagnosed with SIADH is scheduled for surgery in a few days. Which does the nurse expect to be prescribed for this patient to help manage the symptoms until surgery?(Select all that apply)
Signup and view all the answers
Study Notes
Hypothyroidism
- Anticipated findings for a patient with hypothyroidism include slowed reflexes, fatigue, cold intolerance, weight gain, dry skin, hair loss, bradycardia, constipation, and depression.
- Patients may also have hypothermia and anemia.
Diabetes Insipidus
- The nurse should monitor fluid intake and output, urinary specific gravity, and blood sodium levels.
- The nurse should assess for signs of dehydration, such as dry mucous membranes, decreased skin turgor, hypotension, and tachycardia.
- The patient may require replacement therapy with vasopressin or desmopressin (DDAVP).
- The nurse should encourage frequent oral intake, and educate the patient and their family about the disease process, management, and prevention of complications.
Postoperative Thyroidectomy
- The nurse anticipates the HCP to prescribe IV calcium gluconate for a patient experiencing numbness around the mouth and random muscle twitches post-thyroidectomy.
- This is a postoperative complication of hypoparathyroidism
- The nurse should monitor for hypocalcemia, which can manifest as tetany, carpopedal spasm, laryngeal stridor, and seizures.
- The nurse should assess for signs of hypocalcemia and report any changes to the HCP.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
- A contributor to SIADH is small cell lung cancer.
- The nurse must **monitor for complications of SIADH, **which include hyponatremia, changes in mental status, seizures, and coma.
- The nurse should assess for these complications.
- The nurse facilitates treatment by restricting fluid intake and monitoring urine output.
Thyroidectomy for Cancer
- The nurse should anticipate a prescription from the HCP for IV fluids, antipyretics, and a short-acting beta blocker for a patient who has developed fever, tachycardia, and hypertension 6 hours post-thyroidectomy.
- The nurse should monitor for signs of thyroid storm, which can develop due to the release of thyroid hormone into the bloodstream during surgery.
- The nurse should assess the patient for hyperthyroidism and report any changes to the HCP.
Difficulty Speaking, Swallowing, and Frequent Headaches
- The nurse anticipates a magnetic resonance imaging (MRI) scan of the head in addition to a CT scan for a patient reporting with these symptoms.
- These symptoms may be consistent with a tumor or other abnormality in the brain, and an MRI might provide more detailed information about the brain tissue.
Growth Hormone Deficiency
- An appropriate nursing intervention for a patient with GH deficiency is encouraging a high-protein diet.
- Growth hormone deficiency, or hypopituitarism, is a condition in which the pituitary gland does not produce enough growth hormone.
- The nurse can also help motivate the patient to participate in regular exercise.
Diabetes Insipidus Treatment Effectiveness
- A laboratory value that indicates effectiveness of treatment for diabetes insipidus is a normal serum osmolality, which is typically 280-295 mOsm/kg water.
- Diabetes insipidus is a condition in which the body cannot concentrate urine properly, resulting in excessive urination and dehydration.
- The nurse should monitor the patient's urine output and report any changes to the HCP.
Postoperative Transsphenoidal Surgery
-
Nursing care in the postoperative period after transsphenoidal surgery for a pituitary tumor includes:
- Monitoring for signs of cerebrospinal fluid (CSF) leak, such as clear drainage from the nose or mouth.
- Monitoring for signs of meningitis, such as fever, headache, and stiff neck.
- Monitoring for changes in mental status, such as confusion, disorientation, or lethargy.
- Assessing the patient's vital signs, especially the blood pressure and heart rate.
- Providing pain relief as needed.
Hypothyroidism Emergency Department
- The nurse should be concerned about thyroid storm, which is a life-threatening condition that can occur in patients with hypothyroidism.
- Symptoms of thyroid storm include fever, tachycardia, heart failure, delirium, and seizures.
- The nurse should assess the patient's symptoms, provide supportive care, and report any changes to the HCP.
Adrenal Crisis
- The most likely event to have precipitated an adrenal crisis is a stressful event such as a severe illness, surgery, or trauma.
- Adrenal crisis is a life-threatening condition that occurs when the adrenal glands are unable to produce enough cortisol.
- The nurse should monitor for signs of adrenal crisis, and report any changes to the HCP.
- Symptoms of adrenal crisis include hypotension, tachycardia, fever, nausea, vomiting, abdominal pain, weakness, and confusion.
Hypoparathyroidism
- A patient demonstrating success in learning about hypoparathyroidism might say they need to increase their calcium intake,
- Hypoparathyroidism is a condition in which the parathyroid glands do not produce enough parathyroid hormone.
- The nurse should teach the patient about the condition, emphasize the importance of taking calcium and vitamin D supplements, and monitor for signs of hypocalcemia.
Postoperative Hypophysectomy
- The finding that should be reported to the RN or HCP is any clear drainage from the nose or mouth, as this could indicate a CSF leak, which is a serious complication of hypophysectomy.
- Hypophysectomy is a surgical procedure to remove the pituitary gland.
Patient with Hyperthyroidism
- The nurse should encourage nutrition counseling and reinforce the importance of a well-balanced diet with adequate calories, and refer the patient to a registered dietitian for further guidance.
- This patient is experiencing a common symptom of hyperthyroidism, as weight loss is often attributed to increased metabolism and appetite.
- The nurse should monitor the patient's weight and report any concerns to the HCP.
Goiter
- The finding that will prompt the LVN/LPN to notify the RN is if the swelling is rapidly increasing or is painful, as this may indicate thyroiditis.
- Goiter is a swelling of the thyroid gland.
- The nurse should monitor the patient's goiter and report any concerns to the HCP.
Diabetes Insipidus
- The most important nursing intervention for a patient with diabetes insipidus is monitoring the patient's fluid intake and output to ensure that they are drinking enough fluids to avoid dehydration.
- The nurse should report any concerns to the HCP, such as excessive urine output or signs of dehydration.
Water Deprivation Test
- The test result that supports the diagnosis of diabetes insipidus is a failure of the urine osmolality to increase after water deprivation.
- The water deprivation test is a diagnostic test for diabetes insipidus that involves restricting fluids and monitoring urine output.
- The nurse should monitor the patient closely during the test and report any concerns to the HCP.
Cushing Syndrome
- Nursing care for a patient diagnosed with Cushing syndrome should include:
- Monitoring blood pressure for hypertension.
- Monitoring blood glucose levels for hyperglycemia.
- Monitoring for electrolyte imbalances (such as hypokalemia and hypocalcemia).
- Monitoring for mental status changes (such as depression, irritability, and cognitive impairment).
- Assessing for signs of infection (fever, chills, and redness).
- Educating the patient about the condition and its management.
Adrenal Insufficiency
- Another finding that could support adrenal insufficiency is hyperpigmentation.
- Adrenal insufficiency also involves hyperpigmentation due to an increase in adrenocorticotropic hormone (ACTH).
- The nurse should monitor for signs of adrenal insufficiency and report any concerns to the HCP.
- Symptoms of adrenal insufficiency include fatigue, weakness, weight loss, anorexia, nausea, vomiting, diarrhea, abdominal pain, hypotension, hypoglycemia, and hyperkalemia.
Severe Hypertension, Tachycardia, Palpitations, Diaphoresis, and Apprehension
- The question the nurse should ask the patient is: "Have you been taking any over-the-counter cold or cough medications recently?"
- These symptoms indicate a possible hyperthyroid storm or thyroid crisis.
- Certain over-the-counter medications can trigger a thyroid storm in patients with hyperthyroidism.
- The nurse should assess the patient for signs of hyperthyroidism and report any concerns to the HCP.
Hyperthyroidism in Assisted-Living Facility
- The symptoms the nurse should monitor for when concerned about hyperthyroidism are increased appetite, weight loss, fatigue, heat intolerance, increased sweating, palpitations, and tremors
- The nurse should monitor for signs of hyperthyroidism and report any concerns to the HCP.
Discharge After Adrenal Crisis
- The most important instruction for the nurse to reinforce is the importance of carrying a medical identification card that identifies the patient's condition and the need for corticosteroids, as this helps ensure the patient receives the necessary treatment in case of another crisis,
- Addison's disease, also known as primary adrenal insufficiency, results in decreased cortisol production.
- An adrenal crisis is a life-threatening situation that can occur in patients with Addison's disease when cortisol levels are significantly low.
- The nurse should ensure the patient understands their condition, the importance of medication adherence, and how to manage stressful situations.
Long-Term Hypoparathyroidism
-
Key aspects of discharge teaching for long-term hypoparathyroidism include:
- Taking calcium and vitamin D supplements as prescribed.
- Eating a diet rich in calcium, such as dairy products, leafy green vegetables, and fortified foods.
- Avoiding foods high in phosphorus, such as processed meats, colas, and some types of cheese.
- Monitoring for signs of hypocalcemia (tetany, carpopedal spasm, laryngeal stridor, and seizures) and reporting any changes to the HCP.
- Wearing a medical alert bracelet or necklace that identifies the patient's condition.
Radioactive Iodine Uptake Test
-
Symptoms of hyperthyroidism that might be noted on the medical record include:
- Increased appetite and weight loss
- Heat intolerance and excessive sweating
- Palpitations, tachycardia, and arrhythmias
- Tremors and muscle weakness
- Irritability, anxiety, and nervousness
- Insomnia and difficulty concentrating
- Goiter
SIADH Management Prior to Surgery
- The nurse expects that hypertonic saline will be prescribed to the patient with SIADH prior to surgery to help correct the hyponatremia.
- In addition, loop diuretics, such as furosemide, may be prescribed to enhance sodium excretion and help manage the fluid overload.
- These medications will be used to manage the patient's symptoms until surgery is performed.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz focuses on the expected findings when caring for a patient undergoing diagnostic tests for hypothyroidism. It will help nurses identify the symptoms and lab results associated with this condition, enhancing their understanding and care strategies.
