Which of the following statements should the nurse include in the postoperative teaching for a patient diagnosed with thyroid cancer who had a thyroidectomy and is receiving levothyroxine?

Regular follow-up appointments and blood tests are necessary to monitor your thyroid hormone levels.

You may experience weight gain as a side effect of levothyroxine.

You should take your levothyroxine medication with food.

It is important to avoid any dietary restrictions while taking levothyroxine.

Answer and Explanation

The Correct Answer is A

A.   After a thyroidectomy and when receiving levothyroxine, it is essential for the patient to have regular follow-ups and blood tests (specifically TSH and free T4 levels) to ensure the dosage of levothyroxine is appropriate and to monitor for any complications related to the thyroid hormone levels.
B.   Levothyroxine is a thyroid hormone replacement and, when taken appropriately, should help maintain a normal metabolism, potentially preventing weight gain. Weight changes can occur, but they are more likely to be due to improper dosing or underlying issues rather than a direct side effect of the medication itself.
C.   Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes before breakfast, to ensure optimal absorption. Taking it with food can reduce its effectiveness.
D.   While there are no strict dietary restrictions for most patients on levothyroxine, certain foods (such as those high in soy or fiber) can interfere with absorption if consumed around the time of taking the medication. Patients should be informed to take levothyroxine consistently and to wait a while before consuming certain foods that may impact absorption.

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Correct Answer is D

Explanation

A. Trisomy 21 is a chromosomal disorder resulting in Down syndrome. While individuals with Down syndrome have an increased risk of developing certain leukemias (such as acute lymphoblastic leukemia), it is not directly associated with CML.
B. Fragile X syndrome is a genetic condition caused by a mutation in the FMR1 gene on the X chromosome, leading to intellectual disability and other developmental issues. It is not associated with CML or any form of leukemia. This option is unrelated to the genetic abnormalities seen in CML.
C. The BRCA1 gene mutation is associated with an increased risk of breast and ovarian cancers. While mutations in BRCA1 can affect cancer susceptibility, they are not linked to Chronic Myelogenous Leukemia. Thus, this option does not apply to CML.
D. The Philadelphia chromosome is a specific genetic abnormality found in the majority of patients with CML. It results from a translocation between chromosomes 9 and 22, creating the BCR-ABL fusion gene, which produces a tyrosine kinase that drives the proliferation of leukemic cells.

A. "I should not exercise if I develop a leg ulcer." B. "I should buy my shoes in the afternoon." C. "I should dangle my legs when sitting." D. "I must wear compression stockings at all times."

Correct Answer is D

Explanation

A. While it's true that ulcers can be a serious complication of PAD and require careful management, exercise is generally encouraged in patients with PAD as long as it is safe and supervised. Patients should consult their healthcare provider about appropriate exercise, but not exercising altogether can worsen their condition.
B. Buying shoes in the afternoon is advisable because feet can swell throughout the day. It helps ensure a better fit and reduces the risk of blisters or skin breakdown, which is particularly important for clients with PAD.
C. This statement is generally correct, as dangling the legs can help improve circulation in some cases. Clients with PAD often experience relief when their legs are in a dependent position, as it may help increase blood flow to the extremities. However, they should also be encouraged to avoid prolonged periods of sitting.
D. This statement may indicate a misunderstanding. Compression stockings are typically used for venous issues rather than arterial diseases like PAD. In patients with PAD, wearing compression stockings may not be appropriate and could potentially compromise arterial blood flow.

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ABG Value	Normal Range
PH	7.35-7.45
PaCO2	35-45 mm Hg
HCO3-	22-26 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

Which of the following statements should the nurse include in the postoperative teaching for a patient diagnosed with thyroid cancer who had a thyroidectomy and is receiving levothyroxine?

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