A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism.

Which of the following laboratory values should the nurse anticipate an elevation of?

Free T4

Serum T3

Serum T4

Thyroid stimulating hormone (TSH)

Answer and Explanation

The Correct Answer is D

A.   In primary hypothyroidism, the thyroid gland fails to produce sufficient thyroid hormone.
Consequently, free T4 levels are typically decreased.
B.   Although serum T3 levels may also decrease in primary hypothyroidism due to impaired thyroid function, TSH is the primary marker used for diagnosis and monitoring.
C.   Similarly, serum T4 levels may decrease in primary hypothyroidism due to decreased synthesis by the thyroid gland.
D.   In primary hypothyroidism, the anterior pituitary gland releases more TSH to stimulate the thyroid gland to produce thyroid hormones. Therefore, elevated TSH levels are characteristic of primary hypothyroidism.

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Correct Answer is B

Explanation

A. Blood urea nitrogen (BUN) can be affected by factors other than renal function, such as hydration status and protein intake.
B. Serum creatinine is a more specific indicator of renal function because it reflects the glomerular filtration rate (GFR). Elevated levels indicate impaired renal function.
C. Urine-specific gravity can provide some information about renal concentrating ability but is not as specific or sensitive as serum creatinine for assessing overall renal function.
D. Serum sodium levels may be affected by various factors, including hydration status and medications, but they do not directly reflect renal function.

A. Maintain an IV of 0.45% sodium chloride. B. Administer desmopressin acetate 0.2 mg orally. C. Provide a diet containing 2 g of sodium per day. D. Restrict fluid intake to 1,000 mL per day.

Correct Answer is D

Explanation

A. Infusing hypotonic fluids such as 0.45% sodium chloride can exacerbate hyponatremia in a client with SIADH by further diluting serum sodium levels.
B. Desmopressin acetate is a synthetic form of ADH and would exacerbate the symptoms of SIADH by increasing water reabsorption and further diluting serum sodium levels.
C. Increasing dietary sodium intake would not be appropriate for a client with SIADH, as it would contribute to further fluid retention and exacerbate hyponatremia.
D. Fluid restriction is a key component of managing SIADH to prevent further water retention and dilutional hyponatremia. Restricting fluid intake helps to normalize serum sodium levels by allowing excess water to be excreted.

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A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

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A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism.

Which of the following laboratory values should the nurse anticipate an elevation of?