An elderly client with hyperthyroidism asks the nurse if surgery ...

[Sufayan.ah]

An elderly client with hyperthyroidism asks the nurse if surgery is being considered to treat the condition.
 
  After consulting with the physician, the nurse plans to teach the client about the preferred of treatment for hyperthyroidism in older adults, which is which of the following? 1. Partial thyroidectomy
   2. Ingestion of radioactive sodium iodine, I131
   3. Combination treatment with levothroid (Synthroid) and amiodarone (Cordarone)
   4. Remain untreated because there is little affect on the quality of life in older adults

Question 2

How should the nurse position the patient who has decreased cardiac output?
 
  a. semi-Fowler's c. prone
  b. supine d. Sims'

[todom5090]

Answer to Question 1

2. Ingestion of radioactive sodium iodine, I131

Rationale:
Hyperthyroidism in older clients is most often caused by Graves' disease or toxic nodular goiter, which is diagnosed by subnormal or undetectable levels of TSH (thyroid stimulating hormone). The treatment of choice is ingestion of the radioactive iodine, which is picked up by the thyroid tissue and then destroys the tissue. This treatment avoids surgery, anesthesia, and hospitalization. Surgical removal is reserved for clients with symptoms too severe for treatment with radioactive iodine or nodules suspicious for malignancy. Treatment with levothroid (Synthroid) would worsen symptoms, and amiodarone (Cordarone), is an antiarrhythmic drug that has induced hyperthyroidism in some clients. Older clients with hyperthyroidism seldom present with the classic symptoms seen in younger clients, but older clients may develop cardiac dysrhythmias, weight loss, fatigue, and apathy and do require treatment.

Answer to Question 2

A
A patient with decreased cardiac output should not be supine, prone, or side-lying as in the Sims' position. The best position for this patient would be the semi-Fowler's position.