The nurse is performing a physical examination of a patient's thyroid gland. Precautions are taken in performing the correct technique because palpation can result in which occurrence?
Exacerbation of symptoms by releasing additional thyroid hormone.
Weight loss with increased appetite
Hyperthyroidism
Constipation
Hypothyroidism
Increased heart rate, palpitations
Hyperthyroidism
Photophobia, sensitivity to light
Hyperthyroidism
Manic behavior
Hyperthyroidism
Decreased libido
Hypothyroidism
Dyspnea, difficulty breathing
Hyperthyroidism
Insomnia
Hyperthyroidism
Cold tolerance
Hypothyroidism
Increased stools
Hyperthyroidism
Corneal ulcers
Hyperthyroidism
Fatigue, increased sleeping
Hypothyroidism
Irritability
Hyperthyroidism
Impaired memory
Hypothyroidism
Fine, soft, silky body hair
Hyperthyroidism
Facial puffiness
Hypothyroidism
Increased libido
Hyperthyroidism
Heat intolerance, warm skin
Hyperthyroidism
Weight gain
Hypothyroidism
Dry, coarse, brittle hair
Hypothyroidism
Diaphoresis, excessive sweating
Hyperthyroidism
Tremors
Hyperthyroidism
Which factor is a hallmark assessment finding that signifies hyperthyroidism?
Heat intolerance
Which factor is a main assessment that signifies hypothyroidism?
Cold intolerance
Which sign/symptom is one of the first indications of hyperthyroidism that is often noticed by the patient?
Vision changes or tiring of the eyes
Which lab results is consistent with a diagnosis of hyperthyroidism?
Increased serum T3 and T4
The lab results for a 53 year old patient indicate a low T3 level and an elevated TSH. What do these results indicate?
Hypothyroidism
The clinical manifestations of hyperthyroidism are known as which condition?
Thyrotoxicosis
What is the most common cause of hyperthyroidism?
Grave's disease
The nurse assessing a patient palpates enlargement of the thyroid gland, along with noticeable swelling of the neck. How does the nurse interpret this finding?
Goiter
The nurse is assessing a patient diagnosed with hyperthyroidism and observes dry, waxy swelling of the front surfaces of the lower legs. How does the nurse interpret this finding?
Pretibial myxedema
Which statement best describes globe lag in a patient with hyperthyroidism?
Upper eyelid pulls back faster than the eyeball when the patient gazes upward
The nurse is assessing a patient with Grave's disease and observes an abnormal protrusion of both eyeballs. How does the nurse document this assessment finding?
Exophthalmos
Which statements about hyperthyroidism are accurate? Select all that apply.
It is most commonly caused by Grave's disease, it can be caused by overuse of thyroid replacement medication, and serum T3 and T4 results will be elevated.
The nurse is providing instructions to a patient taking levothyroxine. When does the nurse tell the patient to take this medication?
On an empty stomach
The nurse is providing instructions to a patient who is taking antithyroid medication propylthiouracil. The nurse instructs the patient to notify the health care provider immediately if which sign/symptom occurs?
Dark colored urine
A patient who has been diagnosed with Grave's disease is going to receive radioactive iodine in the oral form. What does the nurse teach the patient about how this drug works?
It destroys the tissue that produce thyroid hormones
A patient who has been diagnosed with Grave's disease is going to receive radioactive iodine in the oral form. What instructions does the nurse include in the teaching plan about preventing radiation exposure to others?
Do not share a toilet with others for 2 weeks after treatment, flush the toilet 3 times after each use, wash clothing separate from others in the household, and limit contact with pregnant women, infants, and children.
Which statements about hypothyroidism are accurate?
It occurs more often in women, it can be caused by iodine deficiency, it can be caused by autoimmune thyroid destruction, and myxedema coma is a rare but serious complication.
The nurse is assessing a patient with a diagnoses of Hashimoto's disease. What are the primary manifestations of this disease?
Dysphagia and painless enlargement of the thyroid gland
Lab finding of elevated T3 and T4, decreased T S H, and high thyrotropin receptor antibody titer indicate which condition?
Grave's disease
Automimmune disease; antibodies bind to T S H receptors and keep them activated, increasing the size of the gland and increasing the production of thyroid hormones.
Grave's disease
Uncommon; usually occurs with large follicular carcinomas.
Thyroid carcinoma
T3 and T4 secretion increased before destruction of gland. Hyperthyroid state usually transient.
Thyroiditis, radiation induced
Multiple thyroid nodules resulting in thyroid hyperfunction.
Toxic multinodular goiter
Pituitary adenoma resulting in excessive T S H secretion.
Pituitary hyperthyroidism
A patient is diagnosed with general thyroid enlargement with elevated thyroid hormone level. This is an indication of which condition?
Hyperthyroidism and goiter
Which condition is a life threatening emergency and serious complication of untreated or poorly treated hypothyroidism?
Myxedema coma
A patient with exophthalmos from hyperthyroidism reports dry eyes, especially in the morning. The nurse teaches the patient to perform which interventions to help correct this problem?
Tape the eyes closed with nonallergenic tape
Which factors are considered to be triggers for thyroid storm?
Infection, vigorous palpation of a goiter, and extremely warm temperatures
A patient has the following assessment findings: elevated T S H level, low T3 and T4 level, difficulty with memory, lethargy, and muscle stiffness. These clinical manifestations of which disorder?
Hypothyroidism
A patient has been receiving thyroid hormone for treatment of hypothyroidism. Within what time frame does the patient expect improvement in mental awareness with this treatment?
2 weeks
Which signs and symptoms are assessment findings indicative of a thyroid storm?
Abdominal pain and nausea, fever, tachycardia, and elevated systolic blood pressure
Management of the patient with hyperthyroidism focuses on which glands? Select all that apply.
Blocking the effects of excessive thyroid secretion, treating the signs and symptoms the patient experiences, establishing euthyroid function, and maintaining an environment of reduced stimulation.
Which are preoperative instructions for a patient having thyroid surgery? Select all that apply.
No coughing, deep breathing exercises to prevent strain in suture, manually supporting head and avoid extending neck, hoarseness is usual due to breathing tube, clarify any questions regarding placement, incision, complications, and postoperative care.
The nurse is preparing for a patient to return from thyroid surgery. What priority equipment does the nurse ensure is immediately available?
Tracheostomy equipment, calcium gluconate or calcium chloride for IV administration, humidified oxygen, suction equipment and sandbags.
After a thyroidectomy, a patient reports tingling around the mouth and muscle twitching. Which complication do these assessment findings indicate to the nurse?
Hypocalcemia
The nurse assesses a patient post-thyroidectomy for laryngeal nerve damage. Which findings indicate this complication? Select all that apply.
Hoarseness, weak voice
After hospitalization for myxedema, patient is on thyroid replacement drugs. Which statement by the patient demonstrates a correct understanding of this therapy?
I'll be taking thyroid medication for the rest of my life.
Which statement about thyroiditis are accurate? Select all that apply.
It is an inflammation of the thyroid gland, Hashimoto's disease is the most common type, there are 3 types: acute, subacute, and chronic, and the patient must take thyroid hormones.
Which statement about acute thyroiditis are accurate? Select all that apply.
It is caused by a bacterial infection, it is treated with antibiotics, and manifestations include neck tenderness, fever, and dysphasia or difficulty swallowing.
Serum calcium levels are maintained by which hormone?
Parathyroid hormone P T H
Parathyroid hormone P T H
raises level of serum calcium
Calcitonin production
lowers level of serum calcium levels
Bone changes in adults are often seen with endocrine dysfunction and increased secretion of which substance?
Parathyroid P T H
In addition to regulation of calcium levels, parathyroid P T H and valium regulate the circulating blood levels of which substance?
Phosphate
A patient has a positive Trousseau's or Chvostek's sign resulting from hypoparathyroidism. What condition does this assessment finding indicate?
Hypocalcemia
Which food does the nurse instruct a patient with hypoparathyroid to avoid?
Milk
A patient with continuous spasms of the muscles is diagnosed with hypothyroidism. The muscle spasms are a clinical manifestation of which condition?
Tetany
Chronic kidney disease
Hyperparathyroidism
Vitamin D
Hyperparathyroidism
Removal of the thyroid gland
Hypoparathyroidism
Neck trauma
Hyperparathyroidism
Carcinoma of the lung, kidney, or G I tract producing parathyroid P T H like substance
Hyperparathyroidism
Parathyroidectomy
Hypothyroidism
A patient has hyperparathyroidism and high levels of serum calcium. Which initial treatment does the nurse prepare to administer to the patient.
Force fluids, intravenous or oral, and administer Lasix.
Which are assessment finings of hypocalcemia? Select all that apply.
Numbness and tingling around the mouth, muscle cramping, and mental status changes including irritability.
Which medication therapies does the nurse expect patients with hypoparathyroidism to receive? Select all that apply
Calcium chloride, calcium gluconate, calcitrol, magnesium sulfate, ergocalciferol
Discharge planning for a patient with chronic hypoparathyroidism include which instructions? Select all that apply.
Prescribed medication must be taken for the patient's entire life, and eat foods high in calcium but low in phosphorus
In older adults, assessment findings of fatigue, altered though process, dy skin, and constipation are often mistaken for signs of aging rather than assessment finding for which endocrine disorder?
Hypothyroidism
Which conditions may precipitate myxedema coma? Select all that apply.
Rapid withdrawal of thyroid medication, untreated hypothyroidism, and surgery.