Author Question: A client with hypothyroidism is told by the health care provider that the thyroid-stimulating ... (Read 43 times)

@Brianna17 · **on:** Jul 23, 2018

A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated. The client says to the nurse, I don't understand why my TSH is high. I thought I had low thyroid levels.

The most appropriate response by the nurse is:
1. You probably misunderstood your health care provider.
2. TSH is a hormone released by the pituitary that signals your thyroid to make hormones. When the thyroid can't respond, the pituitary keeps trying to send its signal, and the TSH keeps going up.
3. TSH is not thyroid hormone. When thyroid values are low, other lab tests are performed to see how you tolerate the low levels.
4. TSH is an incomplete thyroid hormone. Because it cannot bind to tissues, it builds up in the bloodstream.

Question 2

The nurse is assisting a postpartum client who is new to breastfeeding. The nurse knows the production of breast milk is dependent on which hormonal mechanism?

1. Follicular-stimulating hormone binding to cells in the ovaries
2. Epinephrine binding to alpha receptors in the blood vessels of the chest wall
3. Luteinizing hormone binding to cells in the ovaries
4. Prolactin binding to receptors in the breast secretory cells

cclemon1 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: This is not an appropriate response. The nurse needs to respond to the client's statement.
Rationale 2: TSH values increase in most cases of hypothyroidism because the thyroid gland is nonresponsive, so the normal negative feedback to the hypothalamus does not occur.
Rationale 3: The information in this statement might be correct; however, it does not address the client's statement about an elevated TSH level.
Rationale 4: TSH is not an incomplete thyroid hormone.
Global Rationale: TSH values increase in most cases of hypothyroidism because the thyroid gland is nonresponsive, so the normal negative feedback to the hypothalamus does not occur. TSH is not an incomplete thyroid hormone. The nurse should directly address the patient's concerns.

Answer to Question 2

Correct Answer: 4
Rationale 1: This hormone does not aid in the production of breast milk.
Rationale 2: This hormone does not aid in the production of breast milk.
Rationale 3: This hormone does not aid in the production of breast milk.
Rationale 4: The production of breast milk is triggered by the release of prolactin by the pituitary gland.
Global Rationale: The production of breast milk is triggered by the release of prolactin by the pituitary gland. FSH, epinephrine, and LH do not directly affect production of breast milk.