ALTERED HORMONAL REGULATION 1. Which hormones can affect metabolism? Select all that apply. tetraiodothyronine (T4) triiodothyronine (T3) thyroid
... [Show More] stimulating hormone (TSH) 1. Which hormone is most likely to affect fluid and electrolyte homeostasis? Antidiuretic hormone. 2. A client with hyperparathyroidism and hypercalcemia is unable to transfer to the bedside commode independently. Nursing assessment reveals hyporeflexia, muscle weakness, increased thirst, and increased urination. On which nursing diagnosis should the nurse focus? Altered mobility. 3. Which client statement indicates the need for further assessment of thyroid function? I noticed that my neck is a bit large and has a lump. I 4. A client visits the clinic after experiencing chest palpitations for the last two days. What is the best question for the nurse to ask first? Has this happened to you before. 5. The client is admitted due to an enlargement of the thyroid gland. The client will undergo computed tomography (CT) scan with contrast media in the morning. What is the most important assessment to prevent further complications? Check the blood urea nitrogen (BUN) and creatinine levels. 6. The client with Cushing’s syndrome secondary to pituitary tumor will undergo computed tomography (CT) scan with contrast media in the afternoon. What is the most important assessment before the procedure to prevent further complications? History of iodine allergies. 7. The client is admitted in the emergency department due to confusion and serum sodium of 120 mEq/L. The nurse should anticipate which diagnostic test will be ordered? Serum antidiuretic hormone. 8. The nurse is assessing a client with a serum calcium level of 7 g/dL experiencing facial twitching and carpopedal spasms. Follow-up assessment by the nurse should focus on clinical manifestations of which hormone imbalance. Parathyroid hormone. 9. Which diagnostic test will be helpful to identify Addison's disease? Dexamethasone stimulation test. 10. 12 hours after an adrenalectomy, the client is being monitored after developing diabetes insipidus. The client's urine output is 200 ml/hour and blood pressure is 98/50 mm Hg. What is the most appropriate nursing diagnosis? Fluid volume deficit. 11. What diagnostic test will be helpful to identify the presence of diabetes insipidus? Water deprivation test. 12. What diagnostic test will be helpful to identify the presence of Cushing’s syndrome? Dexamethasone suppression test. 13. The client has a gunshot wound and went through several surgeries. Postoperatively, the client developed syndrome of inappropriate antidiuretic hormone (SIADH). Currently, the client has high blood pressure and pitting edema on his upper and lower extremities. What is the most appropriate nursing diagnosis? Fluid volume overload. contact: [email protected] HYPERTHYROIDISM 14. Which are the most common risk factors of hyperthyroidism? Select all that apply. Inflammation of thyroid gland, excessive iodine intake, female gender. 15. What are the most common clinical manifestations of clients who have hyperthyroidism? Select all that apply. Systolic hypertension, weakness, Nervousness. 16. Which hormones should be monitored when a client has hyperthyroidism? Select all that apply. Thyroid stimulating hormone (TSH), Triiodothyronine (T3), Tetraiodothyronine (T4). 17. The client will undergo radioactive iodine uptake test. What are the most important assessment findings to prevent complications? Select all that apply. Identify if the client has any allergies, check if the client is pregnant. 18. The client with hyperthyroidism has exophthalmos and eye discomfort. What is the most appropriate nursing action in providing comfort care? Apply artificial tears and use dark eyeglasses when you are going out. 19. The client is prescribed propylthiouracil. What health teaching is important to address to the client while taking this drug? Call your healthcare provider if you are feeling tired and weak. 20. The client is about to undergo thyroidectomy. The healthcare provider ordered Lugol's solution. What is the most important nursing consideration in administering Lugol's solution? Provide straw to the client prior taking the drug. 21. The client is receiving outpatient radioactive iodine therapy. What are the most appropriate health teachings to limit radiation exposures? Select all that apply. Use private toilet facilities, flush your toilet two or three times after using it, separate bed linens and laundering towels. 22. Two hours ago a client had a thyroidectomy. The client feels tired and states having soreness around their neck. The vital signs are T 98.5º Fahrenheit, BP 110/50 mm Hg, RR 22 breaths per minute and oxygen saturation of 95% with a 2 liters per minute via nasal cannula. What are the appropriate nursing actions for this client? Select all that apply. Have a suction and tracheostomy kit at bedside, assist the client to cough and deep breath, monitor calcium levels and assess for any signs of tetany. 23. The client is two days post-operative following a thyroidectomy. Upon assessing the surgical site dressing, the nurse notices that it is soaked with blood. What should the nurse do first? Assess the surgical incision site and the suture. 24. The client had radioactive iodine therapy yesterday. The client states having mouth and throat irritation. What is the most appropriate health teaching for this client? Select all that apply. Offer sips of water or ice chips three or four times per day, offer warm water that has a teaspoon of salt. 25. The client had a thyroidectomy. Two hours after surgery, the client is restless and has involuntary tremors. What should the nurse assess the client for? Hypocalcemia. 26. The client who has hyperthyroidism is being discharged and asking questions about nutritional therapy. What is most important for the client to remember about his diet? You can eat high-caloric diet that is rich in protein and carbohydrates. 27. The nurse should monitor for which complications after a thyroidectomy? Select all that apply. Thyrotoxicosis, infection, hypocalcemia. HYPOTHYROIDISM 28. What are the most common risk factors of hypothyroidism? Select all that apply. Iodine deficiency, women. 29. Which clinical manifestations are commonly found in clients with hypothyroidism? Select all that apply. Constipation, weakness, hypoactive bowel sounds. 30. What laboratory results will most likely support the diagnosis of hypothyroidism? high thyroid stimulating hormone (TSH), low triiodothyronine (T3) and tetraiodothyronine (T4) levels 31. The client with new onset hypothyroidism is concerned about monitoring her weight. What is the most appropriate health teaching to this client? You have to weigh yourself in the morning using the same type of clothing and scale. 32. The client with hypothyroidism who is currently taking levothyroxine. Which clinical manifestation should the client report to their healthcare provider? Palpitations. 33. The client is concerned about risk factors that can predispose them to developing myxedema coma. Which factors should the nurse include in their response? Select all that apply. Infection, cold exposure, trauma. 34. A client with a history of coronary artery disease and diabetes mellitus is currently taking levothyroxine, insulin, and warfarin. The nurse should include which medication interaction information when educating this client? Select all that apply. Levothyroxine can decrease the effect of insulin once thyroid hormone levels normalizes, Levothyroxine can potentiate the effect of warfarin. 35. The client is currently taking insulin and levothyroxine. The nurse should monitor the client for signs of which condition as the client's thyroid hormone levels start to normalize? Hyperglycemia. 36. client with a history of hypothyroidism is brought to the emergency department. Physical assessment findings are hypothermia, hypoventilation, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Laboratory findings reveal respiratory acidosis. The client is developing severe hypothyroidism. For which complication should the nurse monitor? Myxedema coma. 37. The client with hypothyroidism is admitted due to altered level of conscious and low blood pressure. The client is currently lethargic with a T 97.5º F (36°C), HR 55 beats per minute, BP 98/50 mm Hg, RR 15 breaths per minute, and 94% oxygen saturation with 2 liters per minute via nasal cannula. Based on the case scenario, what are the most appropriate nursing diagnoses? Select all that apply. Decreased cardiac output, altered mental status. 38. After receiving change of shift report on four clients with hypothyroidism, the nurse should assess which person first? Client who is lethargic. 39. The client with hypothyroidism developed myxedema coma secondary to pneumonia. The client's current vital signs are T 97º F, HR 55 beats/minute, BP 96/50 mm Hg, RR 18 breaths per minute, and 99% oxygen saturation. The client is currently on full ventilatory support. What are the most appropriate nursing actions to prevent further complications? [Show Less]