A patient presents with a thyroid storm. Which of the following interventions is most appropriate to initially manage this condition?

Administer propranolol intravenously.

Administer dextrose 50% intravenously.

Administer levothyroxine orally.

Administer insulin to control hyperglycemia.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Administering propranolol intravenously is the most appropriate initial intervention for managing a thyroid storm. Thyroid storm is a life-threatening condition characterized by severe hyperthyroidism, leading to symptoms such as tachycardia, hypertension, and hyperthermia. Propranolol, a non-selective beta-blocker, helps control these symptoms by reducing heart rate and blood pressure. Additionally, propranolol inhibits the peripheral conversion of T4 to T3, the more active form of thyroid hormone, thereby reducing the overall thyroid hormone activity. This makes it a critical first step in stabilizing the patient.

Choice B Reason:

Administering dextrose 50% intravenously is not the most appropriate initial intervention for thyroid storm. Dextrose 50% is typically used to treat severe hypoglycemia by rapidly increasing blood glucose levels. While maintaining adequate glucose levels is important, it does not address the primary issue of excessive thyroid hormone activity in thyroid storm.

Choice C Reason:

Administering levothyroxine orally is inappropriate in the context of thyroid storm. Levothyroxine is a synthetic form of T4 used to treat hypothyroidism, not hyperthyroidism. Administering it in a thyroid storm would exacerbate the condition by increasing the levels of thyroid hormone in the body.

Choice D Reason:

Administering insulin to control hyperglycemia is not the primary intervention for thyroid storm. While hyperglycemia can occur in thyroid storm due to increased metabolic activity, the immediate priority is to control the excessive thyroid hormone activity. Insulin administration would be secondary to stabilizing the patient’s thyroid function.

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Correct Answer is A

Explanation

Choice A Reason:

Scleral buckling is a surgical procedure used to treat retinal detachment by indenting the wall of the eye. This technique involves placing a silicone band (buckle) around the sclera (the white part of the eye) to push the wall of the eye against the detached retina. This helps to reattach the retina and prevent further detachment. Scleral buckling is effective in treating many types of retinal detachments and is a common procedure for this condition.

Choice B Reason:

Photorefractive keratectomy (PRK) is a type of refractive surgery used to correct vision problems such as myopia, hyperopia, and astigmatism. It involves reshaping the cornea using a laser but is not used to treat retinal detachment. PRK does not involve indenting the wall of the eye or addressing issues with the retina.

Choice C Reason:

Vitrectomy is a surgical procedure that involves removing the vitreous gel from the eye to treat various eye conditions, including retinal detachment. While vitrectomy can be used to treat retinal detachment, it does not involve indenting the wall of the eye. Instead, it allows the surgeon to access the retina and perform necessary repairs.

Choice D Reason:

Intravitreal injection involves injecting medication directly into the vitreous cavity of the eye. This procedure is used to treat conditions such as macular degeneration, diabetic retinopathy, and retinal vein occlusion. It is not used to treat retinal detachment by indenting the wall of the eye.

A. 18-24 hours after administration B. 4-12 hours after administration C. 12-18 hours after administration D. 1-2 hours after administration

Correct Answer is B

Explanation

Choice A Reason:

NPH insulin is an intermediate-acting insulin that typically has a duration of action of about 12 to 16 hours. The peak action, however, occurs much earlier, making 18-24 hours after administration an incorrect choice for the peak time of hypoglycemia risk.

Choice B Reason:

NPH insulin generally peaks 4 to 12 hours after administration This is the period when the insulin is most effective at lowering blood glucose levels, and therefore, the time when the patient is at the highest risk for hypoglycemia. Monitoring for signs of hypoglycemia during this window is crucial to ensure patient safety.

Choice C Reason:

While NPH insulin can have effects lasting up to 16 hours, the peak action occurs earlier, between 4 to 12 hours. Therefore, 12-18 hours after administration is not the correct time frame for the peak action of NPH insulin.

Choice D Reason:

NPH insulin starts to act within 1 to 2 hours after administration, but this is not the peak time. The peak action, when the risk of hypoglycemia is highest, occurs later, between 4 to 12 hours after administration.

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A patient presents with a thyroid storm. Which of the following interventions is most appropriate to initially manage this condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient presents with a retinal detachment and is being evaluated for appropriate treatment. Which of the following procedures is used to treat retinal detachment by indenting the wall of the eye?

Correct Answer is A

Explanation

A 55-year-old patient with type 2 diabetes is admitted to the hospital and is on NPH insulin. The patient experiences symptoms of hypoglycemia. At what time after administration of NPH insulin should the nurse be most vigilant for signs of hypoglycemia due to the peak action of the insulin?

Correct Answer is B

Explanation

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