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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Caffeine-rich beverages are not recommended for patients with Meniere’s disease. Caffeine can exacerbate symptoms such as vertigo and tinnitus by increasing the fluid pressure in the inner ear. Therefore, avoiding caffeine is generally advised to help manage the condition.
Choice B Reason:
A low-sodium diet is an appropriate treatment for Meniere’s disease. Reducing sodium intake helps decrease fluid retention in the body, including the inner ear, which can alleviate symptoms such as vertigo, tinnitus, and hearing loss. This dietary modification is a cornerstone of managing Meniere’s disease and can significantly improve the patient’s quality of life.
Choice C Reason:
High-intensity interval training (HIIT) is not suitable for patients with Meniere’s disease. Intense physical activity can trigger vertigo attacks and worsen balance issues. Patients are generally advised to engage in moderate, low-impact exercises that do not provoke symptoms.
Choice D Reason:
Prolonged bed rest is not an appropriate treatment for Meniere’s disease. While rest may be necessary during acute vertigo attacks, long-term bed rest can lead to deconditioning and other health issues. It is important for patients to maintain a balance between rest and activity to manage their symptoms effectively.
Correct Answer is D
Explanation
Choice A Reason:
Prescription glasses can help improve vision in the early stages of cataracts by compensating for changes in the lens. However, they do not treat the underlying condition. As cataracts progress, glasses become less effective, and surgery becomes necessary to restore clear vision.
Choice B Reason:
Laser therapy is not used to dissolve cataracts. Instead, it is sometimes used after cataract surgery to treat a condition called posterior capsule opacification, which can occur months or years after the initial surgery. This procedure, known as YAG laser capsulotomy, helps to clear the vision but does not address the primary cataract.
Choice C Reason:
Anti-inflammatory eye drops can be used to manage inflammation and discomfort associated with cataracts or cataract surgery. However, they do not treat or remove the cataract itself. These drops are often part of the post-operative care following cataract surgery.
Choice D Reason:
Cataract surgery is the most effective treatment for cataracts. During the procedure, the clouded natural lens is removed and replaced with a clear artificial lens called an intraocular lens (IOL). This surgery significantly improves vision and is considered the definitive treatment for cataracts.
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