While assessing a client with Graves' disease, the nurse notes that the client's temperature has risen 1° F. Which action should the nurse take first?

Turn the lights down and shut the client's door.

Call for an immediate electrocardiogram (ECG)

Administer a dose of acetaminophen

Calculate the client's apical-radial pulse deficit

Answer and Explanation

The Correct Answer is A

A. Turn the lights down and shut the client's door: Increased body temperature can be an early sign of thyroid storm. Decreasing environmental stimuli (such as light and noise) helps lower stress on the body and may prevent exacerbating the symptoms.

B. Call for an immediate electrocardiogram (ECG): While thyroid storm can cause tachycardia and arrhythmias, an elevated temperature by 1° F alone does not warrant an ECG. The priority is to manage the potential triggers for the rise in temperature first.

C. Administer a dose of acetaminophen: A mild temperature increase in Graves' disease could indicate the beginning of thyroid storm, which requires more immediate interventions like cooling measures and possibly antithyroid medications.

D. Calculate the client's apical-radial pulse deficit: Monitoring for a pulse deficit could be important if the client is experiencing arrhythmias or tachycardia, but the priority is to address the rising temperature and environmental factors, as these can escalate into a thyroid storm.

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Correct Answer is D

Explanation

A. “This medication helps lower my blood sugar by increasing insulin release.": Sitagliptin (Januvia) works by increasing insulin release and decreasing glucagon levels when blood glucose is elevated, helping to lower blood sugar.

B. "I need to keep monitoring my blood sugar regularly while on this medication.": Regular monitoring of blood glucose levels is important to ensure the medication is working effectively and to detect any changes in blood sugar.

C. "I will call my provider if I develop severe abdominal pain that doesn't go away.": Severe abdominal pain can be a sign of a serious side effect such as pancreatitis, and the client should contact their healthcare provider immediately if this occurs.

D. "If I feel nauseated or vomit after taking this drug, I should just wait and see if it gets better.": Nausea and vomiting can be side effects of sitagliptin. If the client experiences these symptoms, they should not simply wait, but instead contact their provider for further guidance, as these symptoms may require adjustments to the treatment plan.

A. hyperthyroidism B. hypothyroidism C. cretinism D. Hashimoto's thyroiditis

Correct Answer is D

Explanation

A. Hyperthyroidism: Hyperthyroidism occurs when there is excessive production of thyroid hormones (T3 and T4), often due to conditions such as Graves' disease. This is not consistent with the autoimmune destruction of enzymes needed to produce T3 and T4.

B. Hypothyroidism: Hypothyroidism occurs when there is insufficient production of thyroid hormones (T3 and T4), often due to damage or dysfunction of the thyroid. This does not result from autoimmune destruction of essential enzymes.

C. Cretinism: Cretinism is a form of hypothyroidism that occurs in infants and children, resulting from a lack of thyroid hormone during development. It is not typically associated with the autoimmune destruction of enzymes as described.

D. Hashimoto's thyroiditis: Hashimoto's thyroiditis is an autoimmune disease where the body produces antibodies that attack the thyroid gland, specifically targeting the enzymes necessary for the production of thyroid hormones (T3 and T4). This leads to hypothyroidism.

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While assessing a client with Graves' disease, the nurse notes that the client's temperature has risen 1° F. Which action should the nurse take first?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a client who has been prescribed sitagliptin (Januvia) for type 2 diabetes. Which statement by the client indicates a need for further teaching?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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