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EDAPT THYROID GLAND DISORDERS NR507
Typology: Exams
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A young adult female presents with complaints of menstrual irregularities, joint pain, muscle weakness, and swelling in the neck. Assessment findings include exophthalmos and pretibial myxedema. Based on these findings, the nurse practitioner (NP) should complete a focused assessment to learn more about the client's choices related to which of the following? Physical activity Dietary intake Use of vitamin supplements Daily caffeine consumption - ANSWER-Dietary Intake-looking for increased or decreased iodine intake Test for primary hypothyroidism - ANSWER-TSH, T3, T Common cause of Hypothyroidism - ANSWER-Hashimotos Thyroiditis Which of the following hormone levels are elevated with primary hypothyroidism - ANSWER-T4, T Which of the following statements best describes the mechanism of action of hyperthyroid medications - ANSWER-Decrease synthesis of thyroid hormones Laboratory testing includes thyroid-stimulating hormone (TSH) levels in combination with thyroxine (T4) and triiodothyronine (T3). - ANSWER-A low TSH with an elevated T3 and T indicates primary hyperthyroidism. A high TSH with an elevated T3 and T4 indicates secondary hyperthyroidism. Which of the following signs or symptoms suggest a diagnosis of hyperthyroidism? Select all that apply.
a-Exophthalmos b-Weight loss c-Increased appetite d-Lack of thirst e-Decreased urine output f-Heat intolerance - ANSWER-A,B,C,F Primary hypothyroidism - ANSWER-Characteristics: Dysfunction is in the thyroid gland, resulting in decreased production of thyroid hormones thyroxine (T4) and triiodothyronine (T3). The pituitary and hypothalamus function correctly, causing increased thyroid-stimulating hormone (TSH) and/or thyroid-releasing hormone (TRH). Secondary hypothyroidism - ANSWER-Characteristics: Dysfunction is in the pituitary gland or hypothalamus, leading to a decreased stimulation of the thyroid gland and subsequent reduction in thyroid hormone production. COngenital Hypothyroidism - ANSWER-Characteristics: Infants with congenital hypothyroidism may have low levels of thyroid hormones needed for growth and brain development. Many countries require testing of newborns to identify and treat congenital hypothyroidism early. In a client with primary hypothyroidism, the anterior pituitary releases , and the thyroid responds by releasing insufficient amounts of thyroid hormone ____________(T3 and T4). The resulting imbalance causes the clinical manifestations of ________and ___________weight gain. - ANSWER-Thyroid-Stimulating Hormone (TSH) Exopthalmos poor sleep An elevated thyroid-stimulating hormone (TSH) level with a low thyroxine (T4) level and a low triiodothyronine (T3) level indicates which of the following conditions?
Repeat thyroid profile in two (2) weeks Prescribe propylthiouracil 50 mg one tablet by mouth three times daily Prescribe levothyroxine 100 mcg one tablet by mouth daily Schedule for radioactive iodine therapy Order thyroid panel in six (6) weeks - ANSWER-levothyroxine 100, thyroid panel in 6 weeks Which of the following statements indicate that more client education is needed? Select all that apply. a-"I can expect it to take six or more weeks before I'm normal." b-"When my labs come back normal, I can stop the medication." c-"I have a problem with my pituitary gland making too much hormone." d-"My problem started with an autoimmune condition." e-"I'll be on this medication for life." - ANSWER-B,C Select the thyroid condition associated with each symptom. Hyperthyroidism - ANSWER-Palpitations Heat intolerance Weight loss Hypothyroidism - ANSWER-weight gain, cold intolerance, constipation, dry skin Leads to Hypothyroidism - ANSWER-Thyroid gland removal, Hashimoto's, iodine deficiency Leads to hyperthyroidism - ANSWER-graves, thyroid adenoma, levothyroxine toxicity