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)
“I will need to have my white blood cell count checked regularly while taking this medication."
“This medication helps by blocking the production of thyroid hormones."
“I need to check my blood glucose levels dally.”
"Once my symptoms improve, I can stop taking the medication without telling my provider."
“If I feel extremely tired or notice yellowing of my skin, I should report it immediately."
Correct Answer : A,B,E
A. “I will need to have my white blood cell count checked regularly while taking this medication.": Propylthiouracil (PTU) can cause agranulocytosis, a condition that reduces the number of white blood cells, increasing the risk of infection. Regular monitoring of the white blood cell count is important to detect this potential side effect early.
B. “This medication helps by blocking the production of thyroid hormones.": Propylthiouracil (PTU) works by inhibiting the production of thyroid hormones in the thyroid gland, which helps in the treatment of hyperthyroidism.
C. “I need to check my blood glucose levels daily.”: PTU does not directly affect blood glucose levels. Monitoring blood glucose is recommended for patients on medications that affect insulin or blood sugar regulation, such as corticosteroids or some antipsychotic medications, not PTU.
D. “Once my symptoms improve, I can stop taking the medication without telling my provider.”: Clients should continue taking PTU as prescribed, even if symptoms improve. Discontinuing the medication without consulting the provider could lead to relapse or worsening of hyperthyroidism.
E. “If I feel extremely tired or notice yellowing of my skin, I should report it immediately.": Fatigue and yellowing of the skin (jaundice) can be signs of liver toxicity, a serious side effect of PTU. Any such symptoms should be reported immediately to prevent further complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hypotension and bradycardia: Hypotension and bradycardia are associated with hypothyroidism or myxedema coma, not thyroid storm. In thyroid storm, the body experiences an increased metabolic rate, leading to elevated heart rate and blood pressure.
B. Decreased respirations and hypoxia: Decreased respirations and hypoxia are indicative of respiratory failure or conditions like severe hypothyroidism or myxedema coma, rather than thyroid storm, which causes increased metabolic demand and elevated respiratory rate.
C. Obstipation and hypoactive bowel sounds: These symptoms are more associated with hypothyroidism or severe constipation, not thyroid storm. In thyroid storm, bowel movements are typically more frequent due to the increased metabolic state.
D. Hyperpyrexia and extreme tachycardia: Thyroid storm is a life-threatening condition characterized by extreme tachycardia, hyperpyrexia (fever), agitation, and other symptoms of increased metabolism. It requires immediate medical intervention to prevent complications.
Correct Answer is ["13"]
Explanation
Calculation:
- Determine the regular insulin dose based on the sliding scale.
The patient's blood glucose before lunch is 278 mg/dL.
According to the sliding scale:
Blood glucose 250-299 mg/dL: 6 units
Therefore, the regular insulin dose is 6 units.
- Calculate the insulin glargine (Lantus) dose.
Client weight = 70 kg.
Prescription for insulin glargine = 0.1 units/kg once daily.
Insulin glargine dose = 0.1 units/kg × 70 kg = 7 units.
- Calculate the total units of insulin to administer.
Total units = Regular insulin units + Insulin glargine units
Total units = 6 units + 7 units
= 13 units.
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