A 28-year-old female client who is in the first trimester of pregnancy is diagnosed with hyperthyroidism. Which of the following would be the preferred treatment for this client?

Radioactive iodine therapy

Levothyroxine

Ketoconazole

Propylthiouracil (PTU)

Answer and Explanation

The Correct Answer is D

A. Radioactive iodine therapy: This is contraindicated during pregnancy as it can harm the fetus and affect thyroid function.
B. Levothyroxine: This is used for hypothyroidism, not hyperthyroidism. For hyperthyroidism, this medication would not be appropriate.
C. Ketoconazole: This is an antifungal and is not used to treat hyperthyroidism.
D. Propylthiouracil (PTU): PTU is the preferred treatment during the first trimester of pregnancy for hyperthyroidism. It inhibits thyroid hormone synthesis and is considered safer than methimazole during early pregnancy.

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Correct Answer is A

Explanation

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

A. B-type natriuretic peptide (BNP) B. Troponin I C. Blood urea nitrogen (BUN) D. Platelet levels

Correct Answer is A

Explanation

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to the heart's response to increased pressure and volume overload. This biomarker is used specifically to diagnose and assess the severity of heart failure.
B. Troponin I: This is a marker for myocardial injury and is used to diagnose acute myocardial infarction rather than heart failure.
C. Blood urea nitrogen (BUN): While elevated BUN can be associated with renal dysfunction or fluid overload in heart failure, it is not specific to diagnosing heart failure.
D. Platelet levels: These are not directly related to diagnosing heart failure and do not provide information about cardiac function.

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A 28-year-old female client who is in the first trimester of pregnancy is diagnosed with hyperthyroidism. Which of the following would be the preferred treatment for this client?

Nursing Test Bank

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