A patient is admitted with a subtotal thyroidectomy. She is returned to the surgical unit after a short stay in the post anesthesia care unit. She is receiving fluids intravenously. When this patient has completely recovered from anesthesia, and her vital signs are stable, which position would be most appropriate for her?

Fowler's

Trendelenburg

Supine

Prone

Answer and Explanation

The Correct Answer is A

A. Fowler's: Fowler's position (sitting or semi-sitting) position helps reduce swelling in the neck area, facilitates breathing, and promotes comfort. It also helps in the prevention of respiratory distress due to potential swelling around the surgical site.

B. Trendelenburg: Trendelenburg position (head down, feet elevated) is typically used for shock or hypotension, but it is not appropriate for a patient recovering from thyroid surgery. It can increase pressure on the neck and exacerbate swelling.

C. Supine: Lying flat on the back (supine) is not recommended post-thyroidectomy as it can lead to neck swelling and compromise the airway. It is better to keep the patient in a more elevated position to reduce the risk of respiratory distress.

D. Prone: The prone position (lying on the stomach) is not appropriate after thyroid surgery, as it could place unnecessary pressure on the neck and surgical site, potentially hindering recovery and breathing.

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Correct Answer is A

Explanation

A. Full therapeutic effect may take 1 to 3 weeks: Levothyroxine (Synthroid) typically starts to show effects within 1 to 3 weeks, but full therapeutic effects may take several weeks to months for symptoms like fatigue and depression to improve.

B. Full therapeutic effect may take up to 4 months: Levothyroxine typically shows initial improvement within 1 to 3 weeks, not 4 months. Full stabilization can take a few months, but this is too long for initial effects.

C. Diarrhea as an early side effect diminishes with time: Levothyroxine does not typically cause diarrhea. Constipation is more common in hypothyroidism, and any gastrointestinal issues should be reported to the provider.

D. Weight gain or edema formation is greatest in the first month: Levothyroxine helps reverse weight gain and edema caused by hypothyroidism. Weight gain is not a side effect of the medication.

A. Give half the prescribed dose and notify the registered nurse (RN). B. Continue to administer the medication C. Stop the medication for 24 hours D. Withhold the medication and notify the RN.

Correct Answer is D

Explanation

A. Give half the prescribed dose and notify the registered nurse (RN): The symptoms described indicate a serious side effectof potassium iodide, such as agranulocytosis(a decrease in white blood cells), and a dose reduction is not recommended in this situation.

B. Continue to administer the medication: Continuing the medication without addressing the symptoms is unsafe. Fever, sore throat, and mouth ulcersare warning signsof a serious adverse effect, such as agranulocytosis, and continuing the medication could cause harm.

C. Stop the medication for 24 hours: Simply stopping the medication for a short period of time is not sufficient. The symptoms need to be reported immediately, and potassium iodideshould be withheld pending further evaluation by the healthcare provider.

D. Withhold the medication and notify the RN: Fever, sore throat, and mouth ulcersare potential signs of a serious adverse reactionlike agranulocytosis, which requires immediate attention. The nurse should withhold the medicationand inform the healthcare provider for further evaluation and guidance.

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Naxlex Comprehensive Predictor Exams

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The physician prescribes levothyroxine (Synthroid). To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to alert the client that:

Correct Answer is A

Explanation

Correct Answer is D

Explanation

A patient with type 1 diabetes mellitus is preparing for a moderate 30-minute exercise period. Which action best indicates understanding of condition management?

The nurse is teaching a client who has been prescribed propylthiouracil (PTU) for hyperthyroidism. Which statement by the client indicates an understanding of the teaching? (Select 3 options)

The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse. "Why don't the people in the United States get goiters as often? Which statement by the nurse is the best response?

A client newly diagnosed with type 2 diabetes mellitus has a nursing diagnosis of Knowledge deficit: diabetes, medical regimen, diet, exercise, and self-care management skills. Which nursing goal is appropriate for this client?

A client tells the nurse about experiencing symptoms of a hypoglycemic insulin reaction. Which action should the nurse take FIRST?

The nurse is caring for a patient scheduled for a thyroidectomy. Which instruction should be included in the preoperative care?

The nurse notes that the HbA1c level of an assigned patient demonstrated a drop from 9.4% to 5.4%. What inference can best be made about this patient?

A nurse is assisting with the plan of care for a client who is 4 hr postoperative from a subtotal thyroidectomy. Which of the following implementations should the nurse recommend?