A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
The TSH is high because of the low production of T4 by the thyroid.
The thyroxine level is low because the TSH level is high.
The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
High thyroxine levels normally occur in breastfeeding infants.
The Correct Answer is A
In a normal infant, T4 levels increase after birth due to stimulation by TSH from the pituitary gland. In this case, the T4 level is low and the TSH level is high, indicating that the thyroid gland is not producing enough T4 in response to TSH stimulation. This suggests that the infant may have congenital hypothyroidism, which requires prompt treatment to prevent developmental delays and other complications.
The low T4 level is not a direct cause of the high TSH level; rather, the high TSH level is a compensatory mechanism to increase T4 production. It is not normal for a breastfeeding infant to have high thyroxine levels. While the thyroid gland may take a few weeks to reach normal function after birth, the persistent low T4 and high TSH levels in this infant suggest a more serious issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse should inspect the posterior oropharynx of a child who is frequently swallowing after tonsillectomy to assess for bleeding or the presence of clots. Swallowing frequently can be a sign of postoperative bleeding, which is a potential complication of tonsillectomy.
Touching the tonsillar pillars to stimulate the gag reflex or asking the child to speak would not provide information about the presence of bleeding.
Assessing for teeth clenching or grinding is not related to this particular observation.
Correct Answer is A
Explanation
Children with autism spectrum disorder may have difficulty with sensory processing, social interactions, and communication, which can contribute to feeding difficulties and failure to thrive. Providing structured meal times is an important intervention to help establish a routine and promote consistency and predictability.
Structured meal times involve setting a specific time for meals and snacks, providing a calm and quiet environment, and limiting distractions. This can help the child focus on the task of eating and reduce sensory overload that may interfere with feeding. The nurse should also ensure that the child is seated comfortably and at an appropriate height for feeding.
Offering food even if disinterested (B), incorporating play during meals (C), and allowing multiple food choices (D) are not necessarily helpful interventions for a toddler with autism spectrum disorder and failure to thrive. Offering food when the child is not interested may reinforce negative feeding behaviors and can contribute to further feeding difficulties. Incorporating play during meals may distract the child from the task of eating and can be counterproductive. Allowing multiple food choices can be overwhelming for the child and may not promote a consistent and structured feeding routine.
Therefore, the nurse should prioritize providing structured meal times as an important intervention for promoting feeding and growth in a toddler with autism spectrum disorder and failure to thrive.
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