A 45-year-old female patient presents with symptoms of weight loss, palpitations, and heat intolerance. Laboratory results reveal elevated T3 and T4 levels and suppressed TSH levels. Considering her clinical presentation and lab results, which of the following treatments is most appropriate for managing her hyperthyroidism?
Methimazole.
Levothyroxine.
Radioactive iodine.
Propranolol.
The Correct Answer is C
Choice A Reason:
Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones. It is commonly used to manage hyperthyroidism, especially in patients who are not candidates for radioactive iodine therapy or surgery. Methimazole is effective in reducing thyroid hormone levels and controlling symptoms, but it requires long-term use and regular monitoring of thyroid function tests.
Choice B Reason:
Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism, not hyperthyroidism. Administering levothyroxine to a patient with hyperthyroidism would exacerbate the condition by increasing thyroid hormone levels. Therefore, it is not an appropriate treatment for managing hyperthyroidism.
Choice C Reason:
Radioactive iodine is a widely used treatment for hyperthyroidism. It works by destroying overactive thyroid cells, thereby reducing the production of thyroid hormones. This treatment is particularly effective for patients with Graves’ disease, toxic multinodular goiter, or toxic adenoma. Radioactive iodine is a definitive treatment that can lead to a permanent resolution of hyperthyroidism, although it may result in hypothyroidism, which can be managed with levothyroxine.
Choice D Reason:
Propranolol is a beta-blocker that helps manage the symptoms of hyperthyroidism, such as palpitations, tremors, and anxiety. While it is useful for symptomatic relief, it does not address the underlying cause of hyperthyroidism. Propranolol is often used in conjunction with other treatments, such as antithyroid medications or radioactive iodine, to provide immediate symptom control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Febrile non-hemolytic transfusion reactions (FNHTRs) are common and typically present with fever, chills, and sometimes rigors. However, they do not usually cause severe symptoms such as back pain and difficulty breathing. FNHTRs are generally less severe and are caused by the recipient’s immune response to donor white blood cells or cytokines in the transfused blood.
Choice B Reason:
Allergic reactions to blood transfusions can range from mild to severe. Mild reactions may include itching, hives, and rash, while severe reactions (anaphylaxis) can cause difficulty breathing and hypotension. However, allergic reactions do not typically cause back pain, which is more indicative of a hemolytic process.
Choice C Reason:
Fluid overload, also known as transfusion-associated circulatory overload (TACO), can occur when too much blood is transfused too quickly. Symptoms include dyspnea, hypertension, and pulmonary edema. While difficulty breathing is a symptom of fluid overload, chills and back pain are not typical features.
Choice D Reason:
Acute hemolytic transfusion reaction (AHTR) is the most likely cause of the patient’s symptoms. AHTR occurs when the recipient’s immune system attacks the transfused red blood cells, leading to their destruction. This reaction can cause severe symptoms such as chills, fever, back pain, and difficulty breathing. It is a medical emergency that requires immediate intervention to prevent serious complications, including kidney failure and shock.
Correct Answer is A
Explanation
Choice A Reason:
Administering intravenous fluids and pain management is the most appropriate initial intervention for a patient with sickle cell anemia presenting with severe pain, fever, and dehydration. Sickle cell crises often lead to severe pain due to vaso-occlusion, where sickled red blood cells block blood flow to various parts of the body. Intravenous fluids help to rehydrate the patient and reduce blood viscosity, which can alleviate the vaso-occlusive crisis. Pain management is crucial to provide relief and improve the patient’s comfort. This approach addresses the immediate symptoms and stabilizes the patient.
Choice B Reason:
Applying cold compresses to the painful areas is not recommended for patients with sickle cell anemia. Cold can cause vasoconstriction, which may worsen the vaso-occlusion and increase pain. Instead, warm compresses are often suggested to help dilate blood vessels and improve blood flow.
Choice C Reason:
Administering antibiotics immediately is not the primary intervention unless there is a clear indication of an infection. While fever can be a sign of infection, it can also occur due to the inflammatory response associated with a sickle cell crisis. The priority is to manage pain and dehydration first, and then evaluate the need for antibiotics based on clinical findings.
Choice D Reason:
Encouraging the patient to perform light exercise is not appropriate during an acute sickle cell crisis. Physical activity can increase oxygen demand and exacerbate the pain and vaso-occlusion. Rest and adequate hydration are more suitable to manage the crisis effectively.
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