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Author Question: A patient in her twenties with Graves' disease who takes methimazole (Tapazole) tells a nurse that ... (Read 56 times)

cabate

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on: Jul 23, 2018
A patient in her twenties with Graves' disease who takes methimazole (Tapazole) tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her?
 
  a. Methimazole is safe to take throughout pregnancy.
  b. Propylthiouracil should be taken throughout her pregnancy.
  c. The patient should discuss changing to propylthiouracil from now until her second trimester with her provider.
  d. The patient should discuss therapy with iodine-131 instead of medications with her provider.

Question 2

A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats per minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.2 F.
 
  The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition?
  a. Cretinism
  b. Graves' disease
  c. Hypothyroidism
  d. Plummer's disease


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Fayaz00962

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Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: C
Methimazole is not safe during the first trimester of pregnancy, because it is associated with neonatal hypothyroidism, goiter, and cretinism; however, it is safe in the second and third trimesters. Propylthiouracil is recommended for pregnant patients only in the first trimester and during lactation only if a thionamide is absolutely necessary. Iodine-131 is used in women older than 30 years who have not responded to medication therapy and is contraindicated during pregnancy.

Answer to Question 2

ANS: C
This patient is showing signs of hypothyroidism: a low heart rate, low temperature, pale skin, and feeling cold and tired. In adults, thyroid deficiency is called hypothyroidism. In children, thyroid deficiency is called cretinism. Graves' disease and Plummer's disease are conditions caused by thyroid excess.


cabate

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


Fayaz00962

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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