A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)
You will take medication for this condition for several months
This condition can cause you to gain weight
We will perform laboratory tests to monitor the effect of your medication
You might notice that you perspire more with this condition
You will need to eat a high-fiber diet to prevent complications of this condition
Correct Answer : B,C,E
Choice A reason: Hypothyroidism requires lifelong levothyroxine because the thyroid gland doesn’t regain function in most cases, such as Hashimoto’s disease. Stating several months misleads the client, implying a temporary treatment, which is inaccurate. This chronic condition demands continuous hormone replacement to maintain metabolism, energy, and organ function. Temporary therapy applies to transient conditions, not primary hypothyroidism, so this statement fails to reflect the long-term nature of management needed.
Choice B reason: Hypothyroidism slows metabolism due to low thyroid hormone levels, reducing basal metabolic rate and calorie burning. This leads to weight gain as energy expenditure drops, even with unchanged diet, a common symptom. Educating clients about this helps them understand and manage expectations, linking it to the condition’s physiology. It’s a key teaching point, as weight gain often prompts diagnosis and motivates adherence to levothyroxine therapy.
Choice C reason: Laboratory tests like TSH and free T4 are essential to monitor levothyroxine’s effectiveness in hypothyroidism, ensuring the dose restores euthyroid status. These tests, typically done every 6-12 weeks initially then annually, guide adjustments to prevent under- or over-treatment. Including this in teaching empowers clients to participate in their care, understanding why follow-ups matter. It reflects standard practice for managing this endocrine disorder accurately.
Choice D reason: Increased perspiration is a hyperthyroidism symptom, where excess thyroid hormone accelerates metabolism, raising body heat. Hypothyroidism, conversely, causes cold intolerance and dry skin due to slowed metabolism, reducing sweat production. This statement contradicts hypothyroidism’s physiology, misinforming the client about expected symptoms. Correct teaching would highlight cold sensitivity instead, aligning with the condition’s impact on thermoregulation and skin.
Choice E reason: Hypothyroidism slows gastrointestinal motility due to decreased thyroid hormone, often causing constipation as a complication. A high-fiber diet increases bulk and promotes bowel movements, preventing this issue. Teaching this dietary adjustment addresses a common, manageable symptom, improving quality of life. It’s a scientifically supported recommendation, as fiber counteracts the sluggish digestion typical in hypothyroid states, making it vital education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A reason: Raising the drainage bag above the abdomen reverses gravity flow, stopping dialysate outflow and worsening the issue in peritoneal dialysis. Fluid drains downward naturally, so elevating the bag traps it, potentially causing discomfort or infection risk from stagnation. This action opposes dialysis mechanics, where the bag must stay low, making it contraindicated and detrimental to treatment efficacy.
Choice B reason: High-Fowler’s position (upright) may shift abdominal contents, but it doesn’t directly resolve catheter blockages or flow issues in peritoneal dialysis. It’s used during infusion to aid breathing, not drainage. Without evidence of respiratory distress, this adjustment lacks priority over actions addressing flow directly, like repositioning, rendering it less effective here.
Choice C reason: Measuring dialysate outflow quantifies the flow reduction, identifying if less fluid returns than infused, signaling obstruction or leakage. This data guides interventions, like catheter checks or flushes, ensuring dialysis removes toxins effectively. It’s a critical step in troubleshooting, providing objective evidence of the problem’s scope, essential for maintaining treatment goals.
Choice D reason: Monitoring the access site for drainage detects leaks or infection—common flow rate culprits—as fluid escaping reduces outflow. Peritonitis risk rises with poor site integrity, necessitating early intervention. This action ensures catheter function and patient safety, directly addressing potential causes of the observed decrease, making it vital.
Choice E reason: Repositioning to the other side relieves catheter kinks or omental wrapping, frequent causes of slow flow in peritoneal dialysis. Shifting position adjusts intra-abdominal pressure, freeing the catheter tip to drain properly. This non-invasive fix restores dialysis efficacy, a standard first-line response, directly tackling mechanical flow issues effectively.
Correct Answer is ["A","B","E"]
Explanation
Choice A reason: Verifying TPN with another RN is a safety protocol for this high-risk, complex solution containing dextrose, amino acids, and lipids. Errors in formulation or additives can cause severe metabolic imbalances or infections. This double-check reduces risks, ensuring the prescribed nutrients match the bag’s contents. It’s a standard of care in TPN administration, protecting the client from potential harm due to preparation mistakes, especially given its central line delivery.
Choice B reason: TPN’s high dextrose content elevates blood glucose, risking hyperglycemia, especially in stressed or diabetic clients. Monitoring serum glucose during infusion allows timely insulin adjustments, preventing complications like osmotic diuresis or ketoacidosis. This action aligns with metabolic management, as TPN bypasses digestion, delivering glucose directly into the bloodstream. Regular checks ensure glycemic control, a critical aspect of safe parenteral nutrition therapy.
Choice C reason: Increasing the TPN infusion rate to catch up if delayed is dangerous, risking fluid overload, electrolyte shifts, and refeeding syndrome. TPN rates are calculated precisely based on caloric and fluid needs, administered via infusion pumps for consistency. Speeding it up disrupts this balance, potentially causing cardiac strain or metabolic chaos. This action violates administration guidelines, making it inappropriate and unsafe.
Choice D reason: Infusing 0.9% sodium chloride instead of TPN lacks calories, amino acids, and lipids, interrupting nutritional support and risking hypoglycemia from prior high-glucose TPN. Protocol recommends 10% dextrose if TPN is unavailable, maintaining some glucose input. Sodium chloride only provides hydration, not sustenance, undermining TPN’s purpose. This substitution fails to meet the client’s metabolic needs, rendering it an incorrect action.
Choice E reason: Daily weights assess fluid balance and nutritional efficacy in TPN clients, detecting overhydration (weight gain) or malnutrition (loss). TPN delivers precise fluid and calories, and weight changes signal adjustments needed in therapy. This non-invasive measure tracks trends, complementing lab data, and is a cornerstone of monitoring. It ensures the treatment meets goals without causing volume-related complications, making it essential.
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