Important update: Healthcare facilities Show
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more UPDATE Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place. UPDATE The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here. UPDATE Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here. Thyroxine (T4) Triiodothyronine (T3), and Calcitonin 3 hormones that are produced and secreted by the thyroid gland A characteristic common to all hormones is that they: Influence cellular activity of specific target tissues A patient is receiving radiation therapy for cancer of the kidney. The nurse monitors the patient for signs and symptoms pf damage to the: A patient has a serum sodium level of 152mEq/L. The normal hormonal response to this situation is:
All cells in the body are believed to have intracellular receptors for: When obtaining subjective data from a patient during assessment of the endocrine system, the nurse asks specifically about: An appropriate technique to use during physical assessment of the thyroid gland is: Having the patient swallow water during inspection and palpation of the thyroid Endocrine disorders often go unrecognized in older adults because: Symptoms are often attributed to aging Excessive facial hair on women Hyperpigmented coloration in lower legs An abnormal finding by the nurse during an endocrine assessment A patient has a serum calcium level of 3mg/dL. If this finding reflects hypoparathyroidism, the nurse would expect further diagnostic testing to reveal: Are measured to determine of goitre due to hyperthyroidism, hypothyroidism, or normal thyroid Recommended for patients with a large goiter that causes trachea compression, when patient do not respond to antithyroid meds, and with thyroid cancer Surgery - thyroidectomy (subtotal thyroidectomy) Voice hoarseness is to be expected Potential hypocalcemia related to injury or removal of parathyroid glands; monitor for hypocalcemia Parathyroid glands can be accidentally removed during thyroid surgery, therefore Use semi-fowler’s position and support head POSTOPERATIVE CARE FOR THYROIDECTOMY The nurse is caring for a patient who is postoperative following a thyroidectomy. A priority of the patient's nursing care includes which action? Assessment of Chvostek's Sign The nurse is caring for a patient who underwent removal of the thyroid gland (thyroidectomy) three days ago. The patient's serum chemistries reveal calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of 4.0 mg/dL. What condition do these findings indicate? The patient experiencing thyrotoxicosis asks the nurse why he or she is being given propranolol. What is the most accurate answer to the patient's question? To block the sympathetic nervous system response to excess thyroid hormone An acute crisis state of hyperthyroidism often precipitated by a physiologic stressor in the patient with hyperthyroidism In developing a teaching plan for the patient with exophthalmos, the nurse understands that the highest priority is placed on: Preventing Corneal Injury A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition? The nurse reviews lab values for a patient who underwent thyroidectomy 48 hours ago. Which finding is of most concern? What is the rationale for checking Trousseau's sign in a patient following a subtotal thyroidectomy? To assess for parathyroid gland injury. A patient scheduled for a thyroidectomy is placed on potassium iodide. When the patient's family asks the nurse why this medication is needed, what is the nurse's best response? "This medication will decrease the vascularity of the thyroid gland." Avoid preparing food for others. Launder personal towels, bed linens, and clothes separately at home. Avoid being close to pregnant women or children for seven days after therapy. When caring for a patient undergoing radioactive iodine therapy in the outpatient setting. The health care provider was unable to spare a patient's parathyroid gland during a thyroidectomy. Which assessments should the nurse prioritize when providing postoperative care for this patient? Monitoring the patient's serum calcium levels and assessing for signs of hypocalcemia A patient who underwent thyroid surgery develops neck swelling. What is the first action that the nurse should take? Assess the patient for signs of hemorrhage Dysrhythmia Systolic murmurs Systolic hypertension Clinical manifestations the nurse expect in a hospitalized patient diagnosed with Graves' disease? The nurse expects that which medication will be included in the drug therapy for a patient that has a thyroxine level of 14 µg/dL? The nurse is caring for patients with thyroid cancer. The nurse recognizes that the one with the poorest prognosis is the patient with which type of cancer? Anaplastic thyroid cancer A patient is scheduled for a bilateral adrenalectomy. What does the nurse include in the discharge teaching for this patient? Lifelong replacement of corticosteroids will be required. In developing a teaching plan for the patient with Addison's disease, what is the nurse's highest priority? Managing lifelong corticosteroid replacement The patient with an adrenal hyperplasia is returning from surgery for an adrenalectomy. For what immediate postoperative risk should the nurse plan to monitor the patient? Rapid blood pressure changes Hypothyroidism that develops in infancy, caused by thyroid hormone deficiencies during fetal or early neonatal life. All infants in Canada are screened for decreased thyroid function at birth (TSH or T4). The nurse creates a plan of care for a patient with Graves' disease. What is an appropriate expected outcome? The patient will demonstrate maintenance of his weight. The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for what manifestation? Presence of bruits upon auscultation of the thyroid gland Presence of goiter detected on palpation of the thyroid gland Presence of clubbed and swollen fingers Manifestations of hyperthyroidism A patient was admitted to an inpatient unit for general weakness. The patient had laboratory tests completed, and the nurse is reviewing the results in the electronic medical record. The primary health care provider suspects hypothyroidism. The nurse recognizes that the patient is experiencing primary hypothyroidism. Which laboratory values support the suspicion of primary hypothyroidism? High thyroid-stimulating hormone level, low thyroxine level A nurse reviewing the recent medical history of a patient with hypoparathyroidism expects to find a history of: The nurse is caring for a patient with hyperthyroidism. What should the nurse teach the patient about dietary intake? Avoid highly seasoned and high-fiber foods. The nurse is performing discharge education for a patient who was admitted for acute hypothyroidism. The patient is undergoing thyroid hormone therapy for the first time. What statement by the patient to the nurse confirms that discharge teaching was effective? "I should take my levothyroxine every morning before eating my breakfast." he nurse is teaching care guidelines to the parent of a child with hypothyroidism. During the follow-up visit, the nurse suspects that the child may be receiving ineffective treatment. Which action of the parent supports the nurse's suspicion? The parent gives the child a thyroid supplement after meals. A patient who is diagnosed with hypothyroidism and coronary artery disease (CAD) states to the nurse, "I am constipated. My spouse wants me to try an enema to help relieve my discomfort." The nurse educates the patient that using enemas is contraindicated due to the diagnosis. Which is the rationale for this contraindication? A patient is scheduled for a total thyroidectomy. What information does the nurse include when teaching this patient about recovery after the procedure? Life-long hormone replacement will be needed. The nurse expects that which drug will be prescribed for the treatment of a patient diagnosed with hyperthyroidism, asthma, and heart disease? The nurse is caring for a patient with a history of hyperthyroidism who was admitted into the hospital with a kidney infection. It is most important that the nurse notify the health care provider if noting which physical sign or symptom? Consume a high-calorie diet. Eat snacks high in protein. Avoid caffeinated beverages Dietary instructions provided to a patient who is diagnosed with hyperthyroidism A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition? Monitor intake and output Ensure that intravenous (IV) calcium is available Assess for numbness and tingling of the hands and mouth Nursing care of a patient who had a parathyroidectomy A patient is just returning to the surgical floor from the recovery room after undergoing a thyroidectomy. What is the nurse's priority nursing intervention? Have a tracheostomy tray at the bedside. Which clinical manifestation is a classic finding in Graves' disease? The nurse is caring for a patient diagnosed with a toxic nodular goiter with painless thyroiditis. The nurse suspects that the patient has an autoimmune disease based on what assessment finding? What is a nursing priority in the care of a patient with a diagnosis of hypothyroidism? Patient teaching related to levothyroxine A patient has just begun long-term corticosteroid therapy. The nurse determines that the patient requires further education when making which statement? "If I begin to gain weight I should stop taking my medication." A patient diagnosed with hyperthyroidism received radioactive iodine one week ago. The patient tells the nurse, "I don't think the medication is working, I don't feel any different." What is the best response by the nurse? "It may take several weeks to see the full benefits of the treatment." A patient who underwent thyroid surgery develops neck swelling. What is the first action that the nurse should take? Assess the patient for signs of hemorrhage Activity intolerance in a patient with hypothyroidism is related to what? Which patient statement indicates the need for further education regarding the management of both cardiac disease and hypothyroidism? "I will use an enema for constipation." A nurse caring for a patient with hyperparathyroidism should monitor the patient for which complication? The nurse assesses a patient that presents with eye protrusion. The patient states, "My eyes are dry and irritated." Based on these data, the nurse expects that what diagnosis will be made? The nurse determines that the patient who is receiving radioactive iodine therapy for the treatment of hyperthyroidism needs additional instructions when the patient makes which statement? "I will need to take antithyroid drugs for three months after I begin RAI therapy." The nurse is preparing to administer levothyroxine to a patient newly diagnosed with hypothyroidism. The patient's resting heart rate is 110. Which initial action should the nurse take? Obtain a blood pressure measurement The nurse reviews lab values for a patient who underwent thyroidectomy 48 hours ago. Which finding is of most concern? The patient experiencing thyrotoxicosis asks the nurse why he or she is being given propranolol. What is the most accurate answer to the patient's question? To block the sympathetic nervous system response to excess thyroid hormone A patient reports "eye problems". On assessment of this patient, the nurse notes exophthalmos. What other abnormal assessments should the nurse expect to find in this patient? Systolic hypertension and increased heart rate The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit? Complaints of extreme fatigue and hair loss. The nurse identifies the client problem "risk for imbalanced body temperature" fort he client diagnosed with hypothyroidism. Which intervention should be included in the plan of care? Discourage the use of an electric blanket. External heat sources (heating pads,electric or warming blankets) should be discouraged because they increase the risk of peripheral vasodilation and vascular collapse. The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective? The client's temperature is WNL The client with hypothyroidism frequently has a subnormal temperature,so a temperature WNL indicates the medication is effective. Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism? Provide six (6) small, well-balanced meals a day. The client with hyperthyroidism has an increased appetite; therefore, well-balanced meals served several times throughout the day will help with the client's constant hunger The client is admitted to the intensive care department diagnosed with myxedemacoma. Which assessment data warrant immediate intervention by the nurse? Pulse oximeter reading of 90%. Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism? Sedatives. Untreated hypothyroidism is characterized by an increased susceptibility to the effects of most hypnotic and sedative agents; therefore, the nurse should question this medication. Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism? "I have noticed all my collars are getting tighter." The 68-year-old client diagnosed with hyperthyroidism is being treated with radio active iodine therapy. Which interventions should the nurse discuss with the client? Explain it will take up to a month for symptoms of hyperthyroidism to subside. Radioactive iodine therapy is used to destroy the overactive thyroid cells. After treatment, the client is followed closely for three (3) to four (4) weeks until the euthyroid state is reached. The nurse is preparing to administer the following medications. Which medication should the nurse question administering? The loop diuretic to the client with a potassium level of 3.3 mEq/L. This potassium level is below normal,which is 3.5 to 5.5 mEq/L. Therefore,the nurse should question administering this medication because loop diuretics cause potassium loss in the urine. Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm? Hyperpyrexia and extreme tachycardia. Hyperpyrexia (high fever) and heart rate above 130 beats per minute are signs of thyroid storm, a severely exaggerated hyperthyroidism. A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially? Maintain a patent airway. A nurse is caring for a client with a dysfunctional thyroid gland and is concerned that the client will exhibit a sign of thyroid storm. Which is an early indicator of this complication? In order to maintain homeostasis, the average adult requires fluids daily Which clinical manifestation is associated with Graves disease?Clinical manifestations of Graves disease include diffuse goiter and symptoms and signs resulting from hyperthyroidism. Graves disease is often associated with ophthalmopathy, which is not found in other etiologies of hyperthyroidism.
What clinical manifestations does the nurse recognize would be associated with a diagnosis of hyperthyroidism?Hyperthyroidism may manifest as weight loss despite an increased appetite, palpitation, nervousness, tremors, dyspnea, fatigability, diarrhea or increased GI motility, muscle weakness, heat intolerance, and diaphoresis.
What are the most common clinical manifestations of clients who have hyperthyroidism?The classic symptoms of hyperthyroidism include heat intolerance, tremor, palpitations, anxiety, weight loss despite a normal or increased appetite, increased frequency of bowel movements, and shortness of breath.
What kind of signs and symptoms would a patient with untreated Graves disease present with?What are the symptoms of Graves' disease?. weight loss, despite an increased appetite.. rapid or irregular heartbeat.. nervousness, irritability, trouble sleeping, fatigue.. shaky hands, muscle weakness.. sweating or trouble tolerating heat.. frequent bowel movements.. an enlarged thyroid gland, called a goiter.. |
Which clinical manifestations would the nurse assess in a hospitalized patient diagnosed with Graves
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