A client with the diagnosis of hypothyroidism has diminished bowel sounds and reports feeling constipated. Which action should the practical nurse (PN) implement?
Withhold the next scheduled dose of levothyroxine.
Obtain the supplies needed for insertion of a nasogastric tube.
Assist the client with ambulation in the room and hallway.
Remove any food or fluid from the client's bedside and room.
The Correct Answer is C
A. Withhold the next scheduled dose of levothyroxine: Levothyroxine should not be withheld for constipation, as it is the primary treatment for hypothyroidism. Stopping the medication could worsen metabolic function and is not indicated for mild gastrointestinal symptoms.
B. Obtain the supplies needed for insertion of a nasogastric tube: Inserting a nasogastric tube is invasive and unnecessary for constipation unless there is severe obstruction or other complications. Routine constipation is managed with noninvasive measures first.
C. Assist the client with ambulation in the room and hallway: Physical activity stimulates bowel motility and helps relieve constipation. Assisting the client with safe ambulation supports gastrointestinal function and promotes overall recovery in hypothyroid patients.
D. Remove any food or fluid from the client's bedside and room: Restricting food and fluid would worsen constipation and is inappropriate. Adequate hydration and dietary intake are essential for promoting normal bowel function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Bruising: Bruising is typically associated with platelet disorders or vitamin K deficiency, not directly with low calcium levels. While it should be monitored, it is not a primary concern for hypocalcemia.
B. Pallor: Pallor usually indicates anemia or reduced perfusion. Low serum calcium does not directly cause pallor, so it is not the most relevant finding to monitor in this case.
C. Jaundice: Jaundice reflects elevated bilirubin levels and liver dysfunction. It is unrelated to calcium deficiency and does not need to be a primary focus of monitoring in this client.
D. Tetany: Hypocalcemia increases neuromuscular excitability, which can lead to tetany, characterized by muscle spasms, cramping, and positive Chvostek or Trousseau signs. Monitoring for tetany is essential for clients with low serum calcium to prevent complications.
Correct Answer is A
Explanation
A. Coffee-ground secretions draining via nasogastric tube suction: Coffee-ground emesis indicates the presence of partially digested blood, suggesting gastrointestinal bleeding. This is a potentially life-threatening condition that requires immediate reporting and prompt intervention.
B. Oral ice chips 30 minutes eaten after vomiting postoperatively: Offering ice chips shortly after vomiting is generally safe and may help prevent dehydration. While the PN should monitor for further vomiting, this finding does not require immediate reporting.
C. Inability to void 4 hours after discontinuing an indwelling catheter: Postoperative urinary retention is important to monitor, but a 4-hour delay in voiding is often within acceptable limits and can be managed with assessment and interventions.
D. Ineffective pain management reported while using morphine PCA: Ineffective pain control should be addressed promptly, but it is not immediately life-threatening. The RN can evaluate dosage adjustments or interventions without urgent escalation unless the client exhibits signs of severe distress or complications.
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