The nurse is caring for a patient with Graves Disease and anemia who had a thyroidectomy two days ago.
Based on the laboratory results below, which medication will the nurse administer first? Creatinine 1.2 mg/dL. Calcium 8.5 mg/dL. Hemoglobin 12 g/dL. Hematocrit 36%.

Levothyroxine 50 mcg orally.

Calcium gluconate 45 mg intravenously.

Epoetin alfa 300 units per kilogram subcutaneously.

Potassium chloride 40 mEq orally.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Levothyroxine is used for the replacement of thyroid hormone in patients with hypothyroidism. While it is essential for long-term management of thyroidectomy patients, it is not the immediate priority. The patient’s calcium levels are low, indicating the need for urgent correction to prevent complications such as tetany or cardiac issues.

Choice B rationale

Calcium gluconate is crucial to administer first in this scenario because the patient's calcium level is 8.5 mg/dL, which is on the lower end of the normal range. After a thyroidectomy, patients are at risk of hypocalcemia due to potential damage to the parathyroid glands, which regulate calcium levels. Intravenous calcium gluconate helps rapidly correct any deficiency and prevents severe symptoms like muscle cramps, tingling, or cardiac arrhythmias.

Choice C rationale

Epoetin alfa is used to stimulate red blood cell production in patients with anemia, particularly those with chronic kidney disease or undergoing chemotherapy. Although this patient has anemia, indicated by a hemoglobin level of 12 g/dL and hematocrit of 36%, the levels are not critically low. Addressing the low calcium level takes precedence to prevent immediate life-threatening complications.

Choice D rationale

Potassium chloride is used to treat or prevent potassium deficiency. The patient’s laboratory results do not indicate any abnormality in potassium levels, making this medication unnecessary at this time. Administering it without indication could lead to hyperkalemia, which poses risks such as cardiac dysrhythmias.

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Correct Answer is D

Explanation

Choice A rationale

Hypoventilation and hypoglycemia are symptoms of untreated hypothyroidism rather than an indicator of effective levothyroxine treatment.

Choice B rationale

Angina and arrhythmias can occur if the dosage of levothyroxine is too high, indicating overmedication rather than effective treatment.

Choice C rationale

Weight gain is a sign of undertreated hypothyroidism and would indicate that the medication is not effective in managing the condition.

Choice D rationale

Normal body temperature and pulse rate indicate that levothyroxine is effectively managing the symptoms of hypothyroidism, as it restores metabolic function to normal levels. .

A. Refer the patient to the psychiatrist for anti-depressant medications. B. Provide portable oxygen therapy via nasal cannula during physical activity. C. Instruct the patient to increase their oral iron supplement dose until fatigue subsides. D. Encourage the patient to perform light exercises daily.

Correct Answer is B

Explanation

Choice A rationale

Referring the patient to a psychiatrist for anti-depressant medications may not address the immediate issue of fatigue and breathlessness related to acute leukemia. While psychological support is important, the primary focus should be on managing the patient's physical symptoms and improving oxygenation during activities.

Choice B rationale

Providing portable oxygen therapy via nasal cannula during physical activity is the best intervention for this patient. Oxygen therapy can help alleviate the patient's symptoms of breathlessness and fatigue by ensuring adequate oxygen levels during physical exertion. This intervention allows the patient to engage in activities with less discomfort and prevents further complications related to hypoxia.

Choice C rationale

Instructing the patient to increase their oral iron supplement dose until fatigue subsides is not appropriate without medical supervision. Iron supplementation should be based on the patient's iron levels and hematologic status. Over-supplementation can lead to adverse effects and may not address the underlying cause of fatigue in patients with acute leukemia.

Choice D rationale

Encouraging the patient to perform light exercises daily can be beneficial for overall health, but it may not be practical for someone experiencing severe fatigue and breathlessness. The patient's immediate need for oxygen support during activities takes precedence, and physical activity should be tailored to their current capabilities and medical condition. .

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The nurse is caring for a patient with Graves Disease and anemia who had a thyroidectomy two days ago.Based on the laboratory results below, which medication will the nurse administer first? Creatinine 1.2 mg/dL. Calcium 8.5 mg/dL. Hemoglobin 12 g/dL. Hematocrit 36%.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with hypothyroidism who is prescribed levothyroxine.Which assessment data indicates to the nurse that the medication has been effective?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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The nurse is caring for a patient with Graves Disease and anemia who had a thyroidectomy two days ago.
Based on the laboratory results below, which medication will the nurse administer first? Creatinine 1.2 mg/dL. Calcium 8.5 mg/dL. Hemoglobin 12 g/dL. Hematocrit 36%.