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Questions and Answers
A nurse develops plan of care for client with hyperthyroidism and includes which of the following with the plan?
A nurse develops plan of care for client with hyperthyroidism and includes which of the following with the plan?
- Provide extra blankets
- Provide small meals (correct)
- Provide high fiber diet
- Provide a restful environment (correct)
A nurse is performing an assessment on a client following a thyroidectomy. The nurse notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate?
A nurse is performing an assessment on a client following a thyroidectomy. The nurse notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate?
- Reassure the client that this is usually a temporary condition
- Check for signs of bleeding
- Administer calcium gluconate
- Notify physician immediately (correct)
A client is taking NPH insulin daily every AM. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:
A client is taking NPH insulin daily every AM. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:
- 6-14 hours after administration (correct)
- 16-18 hours after administration
- 18-24 hours after administration
- 2-4 hours after administration
A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot care. Which instruction is included in the plan?
A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot care. Which instruction is included in the plan?
A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would prepare immediately to initiate which of the following anticipated physician's orders?
A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would prepare immediately to initiate which of the following anticipated physician's orders?
A client newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
A client newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency room. Which finding would a nurse expect to note as confirming this diagnosis?
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency room. Which finding would a nurse expect to note as confirming this diagnosis?
A nurse teaches a client with diabetes mellitus about differentiating between Hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which of the following symptoms develop?
A nurse teaches a client with diabetes mellitus about differentiating between Hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which of the following symptoms develop?
A client with diabetes demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to:
A client with diabetes demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to:
A nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client states,
A nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client states,
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of regular insulin is initiated along with intravenous rehydration with a normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which of the following?
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of regular insulin is initiated along with intravenous rehydration with a normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which of the following?
A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism. A nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for:
A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism. A nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for:
A Physician prescribes levothyroxine sodium (Synthroid), 0.15 mg PO daily, for a client with hypothyroidism. A nurse will prepare to administer this medication
A Physician prescribes levothyroxine sodium (Synthroid), 0.15 mg PO daily, for a client with hypothyroidism. A nurse will prepare to administer this medication
A nurse monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which of the following, if exhibited in the client, would indicate hyperglycemia and warrant physician notification?
A nurse monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which of the following, if exhibited in the client, would indicate hyperglycemia and warrant physician notification?
A nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The priority nursing diagnosis would be
A nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The priority nursing diagnosis would be
A client with type 2 diabetes mellitus has a blood glucose greater than 600 mg/dL and is complaining of polydipsia, polyuria, weight loss, and weakness. A nurse reviews physician's documentation and would expect to note which of the following diagnoses?
A client with type 2 diabetes mellitus has a blood glucose greater than 600 mg/dL and is complaining of polydipsia, polyuria, weight loss, and weakness. A nurse reviews physician's documentation and would expect to note which of the following diagnoses?
A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temperature of 101°F, pulse of 88, respirations of 22, and blood pressure of 140/84 mm Hg. Which finding would be most concerning to the nurse?
A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temperature of 101°F, pulse of 88, respirations of 22, and blood pressure of 140/84 mm Hg. Which finding would be most concerning to the nurse?
A nurse is providing discharge instructions to a client who has Cushing's syndrome. Which statement by the client indicates that instructions related to dietary management were understood?
A nurse is providing discharge instructions to a client who has Cushing's syndrome. Which statement by the client indicates that instructions related to dietary management were understood?
A nurse is completing an assessment on an older client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder?
A nurse is completing an assessment on an older client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder?
A nurse is caring for a postoperative parathyroidectomy client. Which client complaint would indicate that a serious, life-threatening complication may be developing, requiring immediate notification of the physician?
A nurse is caring for a postoperative parathyroidectomy client. Which client complaint would indicate that a serious, life-threatening complication may be developing, requiring immediate notification of the physician?
A client who currently is taking levothyroxine sodium (Synthroid) complains of cold intolerance, constipation, dry skin, weight gain, and puffy eyes. Based on these findings, the nurse would anticipate which of the following prescriptions?
A client who currently is taking levothyroxine sodium (Synthroid) complains of cold intolerance, constipation, dry skin, weight gain, and puffy eyes. Based on these findings, the nurse would anticipate which of the following prescriptions?
A nurse is preparing to provide instructions to a client with Addison's disease regarding diet therapy. The nurse knows that which of the following diets most likely would ne prescribed for this client?
A nurse is preparing to provide instructions to a client with Addison's disease regarding diet therapy. The nurse knows that which of the following diets most likely would ne prescribed for this client?
A nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder?
A nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder?
Post thyroidectomy nursing care includes which measures?
Post thyroidectomy nursing care includes which measures?
Which medication will the nurse have available for emergency treatment of tetany in a post thyroidectomy patient?
Which medication will the nurse have available for emergency treatment of tetany in a post thyroidectomy patient?
When caring for a client in a thyroid crisis, the nurse would question an order for:
When caring for a client in a thyroid crisis, the nurse would question an order for:
A client is prescribed levothyroxine (Synthroid) daily. The most important instruction to give the client for administration of this drug is:
A client is prescribed levothyroxine (Synthroid) daily. The most important instruction to give the client for administration of this drug is:
The nurse performing an assessment of a client who has been receiving long term steroid therapy would expect to find:
The nurse performing an assessment of a client who has been receiving long term steroid therapy would expect to find:
A client is scheduled for a routine glycosylated hemoglobin test. What is important for the nurse to tell the client before this test?
A client is scheduled for a routine glycosylated hemoglobin test. What is important for the nurse to tell the client before this test?
What is a characteristic symptom of hypoglycemia that should alert the nurse to an early insulin reaction?
What is a characteristic symptom of hypoglycemia that should alert the nurse to an early insulin reaction?
Flashcards
What is hyperthyroidism?
What is hyperthyroidism?
Hyperthyroidism is a condition of overactive thyroid gland, leading to increased metabolism. It often causes rapid heartbeat, weight loss, and increased appetite.
Why is hoarseness after thyroidectomy concerning?
Why is hoarseness after thyroidectomy concerning?
Hoarseness and a weak voice after thyroidectomy could be a sign of damage to the recurrent laryngeal nerve, which controls the vocal cords.
When is a hypoglycemic reaction most likely after NPH insulin?
When is a hypoglycemic reaction most likely after NPH insulin?
NPH insulin is an intermediate-acting insulin. Peak action occurs 6-14 hours after injection, making this the most likely time for hypoglycemia.
Why should a diabetic client not cut their own toenails?
Why should a diabetic client not cut their own toenails?
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What is the immediate treatment for HHNS?
What is the immediate treatment for HHNS?
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Why is rotating insulin injection sites important?
Why is rotating insulin injection sites important?
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What are the main characteristics of DKA?
What are the main characteristics of DKA?
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What symptom should a diabetic take glucose for?
What symptom should a diabetic take glucose for?
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How to reduce anxiety in a diabetic patient?
How to reduce anxiety in a diabetic patient?
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What action prevents DKA?
What action prevents DKA?
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Why is dextrose infusion given after insulin drip?
Why is dextrose infusion given after insulin drip?
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What side effect should a nurse monitor for in a patient taking PTU?
What side effect should a nurse monitor for in a patient taking PTU?
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When should levothyroxine be administered?
When should levothyroxine be administered?
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What symptom indicates hyperglycemia?
What symptom indicates hyperglycemia?
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What is the priority nursing diagnosis for a hyperglycemic diabetic?
What is the priority nursing diagnosis for a hyperglycemic diabetic?
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What symptoms suggest DKA?
What symptoms suggest DKA?
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What finding is most concerning in a diabetic client?
What finding is most concerning in a diabetic client?
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What dietary management is crucial for Cushing's syndrome?
What dietary management is crucial for Cushing's syndrome?
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What symptom is characteristic of hyperparathyroidism?
What symptom is characteristic of hyperparathyroidism?
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What symptom after parathyroidectomy requires immediate attention?
What symptom after parathyroidectomy requires immediate attention?
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What action is likely needed for hypothyroid symptoms after levothyroxine?
What action is likely needed for hypothyroid symptoms after levothyroxine?
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What is the dietary management for Addison's disease?
What is the dietary management for Addison's disease?
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What is the pathophysiology of Cushing's disease?
What is the pathophysiology of Cushing's disease?
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Why is checking the dressing essential after thyroidectomy?
Why is checking the dressing essential after thyroidectomy?
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What medication is used for emergency tetany after thyroidectomy?
What medication is used for emergency tetany after thyroidectomy?
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What is a questionable order for a patient in thyroid crisis?
What is a questionable order for a patient in thyroid crisis?
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What should the client be instructed to report regarding Synthroid?
What should the client be instructed to report regarding Synthroid?
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What side effect is expected with long-term steroid therapy?
What side effect is expected with long-term steroid therapy?
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What is important for a client before a glycosylated hemoglobin test?
What is important for a client before a glycosylated hemoglobin test?
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What symptom indicates early hypoglycemia?
What symptom indicates early hypoglycemia?
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Study Notes
Hyperthyroidism Care Plan
- A care plan for a client with hyperthyroidism should include small meals, and a restful environment.
Thyroidectomy Assessment
- A client who has had a thyroidectomy and has hoarseness and a weak voice should have signs of bleeding checked.
- Reassurance that the voice change is temporary is appropriate.
- Calcium gluconate may be needed.
Hypoglycemia Risk
- The most likely time for a hypoglycemic reaction in a client taking NPH insulin daily in the morning is 6–14 hours after administration.
Diabetic Foot Care
- A teaching plan for clients with diabetes mellitus should include instructions on proper foot care, such as avoiding hot water soaks for feet, using lotion on dry areas of the feet, and avoiding cutting toenails yourself. A podiatrist should perform toenail care.
Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
- If a client is in an unresponsive state and diagnosed with HHNS, the nurse should prepare for an intravenous infusion of normal saline.
- The initial blood glucose level is likely high (above 950 mg/dL).
- The prescribed medication, following the correct blood glucose reduction, is the intravenous infusion of regular insulin.
Insulin Therapy Teaching
- Clients newly diagnosed with diabetes mellitus need teaching on insulin administration, including when and why to increase the amount of insulin before exercise, that ketones in the urine indicate a need for increased insulin, and that insulin vials should be kept at room temperature, (Insulin injection sites (should be rotated).
Diabetic Ketoacidosis (DKA)
- A client with DKA may present with elevated blood glucose and a low plasma bicarbonate level.
- Increased respirations and an increased pH are not typical findings in DKA.
- A client would likely exhibit a finding of an increased respiratory rate.
Diabetic Ketoacidosis (DKA) Client Assessment
- The nurse should avoid administering sedatives to an anxious client, but should convey empathy, trust, and respect to decrease anxiety.
- The client needs to understand the condition, but the nurse must be supportive.
- Nurses need to recognize a patient's awareness of signs that need to be reported (e.g., blood glucose over 250mg/dL)
- The client with DKA needs intravenous fluids and rehydration using normal saline .
Hyperthyroidism Medication Instructions
- A client taking levothyroxine sodium should ideally take the medicine daily in the morning to prevent sleeplessness.
Hyperglycemia Signs
- Signs of hyperglycemia that require physician notification may include polyuria (frequent urination).
Hyperglycemia Priority Nursing Diagnosis
- The priority nursing diagnosis for a client with hyperglycemia would be a risk for deficient fluid volume.
Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) Diagnosis
- Clients with HHNS likely have a blood glucose level over 600 mg/dL and show symptoms like polydipsia and polyuria, weight loss, and weakness.
- The diagnosis may be hyperglycemic hyperosmolar nonketotic syndrome (HHNS).
Physical Assessment in Diabetes
- In a client with type 2 diabetes, the finding of highest concern for a nurse during a physical assessment would be a temperature over 101 F.
Cushing's Syndrome Dietary Instructions
- Clients with Cushing's syndrome should be instructed to limit the amount of protein in their diet.
Hypothyroidism Medication Adjustments
- A client taking levothyroxine sodium should not discontinue or adjust the dosage without consulting a medical professional after monitoring the T4 level.
- Symptoms like cold intolerance, constipation, dry skin, weight gain, and puffy eyes when a person is taking levothyroxine sodium suggest the dosage should be decreased.
Addison's Disease Diet
- Clients with Addison's disease should follow a diet with a normal sodium intake, rather than a low sodium intake or one that's high in fat (or low in protein or carbohydrates).
Post-Thyroidectomy Medications
- Calcium gluconate is typically available for emergency use to treat tetany (muscle spasms) in a post-thyroidectomy patient. Sodium bicarbonate may also be considered.
Post-Thyroidectomy Care
- Post-thyroidectomy care includes assessing for hoarseness (using assessment tools) and continuous monitoring, checking the dressing around the neck for bleeding, and potentially a low calcium diet.
Hypoglycemia Symptoms
- Early signs of an insulin reaction (e.g., hypoglycemia) might include diaphoresis (sweating).
Parathyroid Assessment
- A client with primary hyperparathyroidism might complain of polyuria.
- A serious complication after parathyroidectomy is possible and it can be identified by sudden symptoms requiring prompt notification of the physician- such as difficulties with voiding, abdominal cramps, or stridor, for example).
- Mild to moderate incisional pain is a more common complaint.
Thyrotoxic Crisis
- A thyroid crisis could require the nurse to question an IV fluids order, and suggest propranolol (Inderal) instead.
- Avoiding propylthiouracil (PTU) and hyperthermia blankets is important.
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Description
This quiz covers essential nursing care plans for patients with hyperthyroidism, post-thyroidectomy assessments, hypoglycemia management, and diabetic foot care. It also addresses complications such as Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS). Test your knowledge on these critical nursing topics to enhance patient care.
