A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Hypercalcemia and hyperkalemia

Muscle twitching and tingling around the mouth

Harsh, vibratory breath sounds

Hyperthermia and hypertension

Answer and Explanation

The Correct Answer is B

A. Hypercalcemia and hyperkalemia: These are not typical indicators of parathyroid damage. Hypercalcemia usually results from overactive parathyroid glands, while hyperkalemia is not a common result of parathyroid damage.
B. Muscle twitching and tingling around the mouth: These symptoms are indicative of hypoparathyroidism, a condition that can occur if the parathyroid glands are damaged during thyroid surgery. This results in hypocalcemia (low calcium levels), which causes neuromuscular symptoms like muscle twitching and tingling.
C. Harsh, vibratory breath sounds: These are not related to parathyroid damage. They may suggest respiratory issues, not problems with calcium regulation.
D. Hyperthermia and hypertension: These are not associated with parathyroid damage. They may be related to other post-surgical complications but not specifically to parathyroid gland injury.

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Correct Answer is D

Explanation

A. Ataxic dysarthria: This is not a common complication associated with Cushing syndrome. It is more related to neurological disorders affecting speech and coordination.
B. Hypotension: Cushing syndrome typically causes hypertension rather than hypotension due to fluid retention and increased vascular resistance.
C. Hyperkalemia: Cushing syndrome is associated with hypokalemia rather than hyperkalemia due to the effects of excess cortisol on potassium levels.
D. Bone fracture: Cushing syndrome increases the risk of osteoporosis and bone fractures due to prolonged exposure to high levels of cortisol, which affects bone density and strength.

A. It is important that you taper off of the corticosteroids you are taking which have caused this disorder. B. You will need to have your adrenal glands removed to reverse your symptoms. C. You will need to begin taking hydrocortisone, and increase your dose during times of stress. D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected.

Correct Answer is B

Explanation

A. It is important that you taper off of the corticosteroids you are taking which have caused this disorder: This statement is not applicable because the client has a pituitary adenoma causing Cushing disease, not iatrogenic Cushing syndrome from corticosteroid use.
B. You will need to have your adrenal glands removed to reverse your symptoms: For Cushing disease caused by a pituitary adenoma, treatment typically involves surgical removal of the pituitary tumor, not the adrenal glands.
C. You will need to begin taking hydrocortisone, and increase your dose during times of stress: This is incorrect as hydrocortisone replacement is used for Addison's disease, not for managing Cushing disease.
D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected: While glucose monitoring might be necessary due to hyperglycemia, the primary treatment for Cushing disease involves addressing the source of excess cortisol, which is the pituitary adenoma.

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A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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