A 32-year-old female patient has just had blood drawn; the ...

[jrubin]

A 32-year-old female patient has just had blood drawn; the results show a TSH level of 0.1 microunits/mL. After feeling different for longer than 6 months, the patient finally came to the clinic.
 
  Assessment reveals insomnia, rapid speech, muscle weakness, intolerance to heat, and in-creased appetite. The nurse suspects ______________ and anticipates that the most preferred treatment will include ___________________ _. a. myxedema; 1 year of suppressive medications
  b. Graves' disease; thyroid supplements
  c. Plummer's disease; surgery or radiation therapy
  d. thyroid storm; long-term thyroid replacement medications

Question 2

A nurse counsels a patient who is to begin taking gamma-hydroxybutyrate (Xyrem) for narcolepsy. It is important for the nurse to warn the patient that respiratory depression is a poten-tial risk with concomitant use of
 
  a. alcohol.
  b. beta blockers.
  c. caffeine.
  d. nicotine.

[ktidd]

Answer to Question 1

C
The signs and symptoms displayed are consistent with Plummer's disease. Antithyroid drugs are needed to manage the high T3 and T4 levels.
Myxedema is manifested by hair loss, fatigue, lethargy, intolerance to cold, brittle hair, and a puffy, pale face.
Graves' disease is similar to Plummer's disease but typically exhibits exophthalmos.
Thyroid storm is manifested by severe hyperdynamics that is life threatening, which this patient does not have. Thyroid storm may be brought on in patients with severe thyrotoxicosis if the pa-tient undergoes major surgery or develops a severe systemic illness.

Answer to Question 2

A
The nurse should advise the patient to avoid alcohol when taking gamma-hydroxybutyrate, be-cause combining the two increases the risk of respiratory depression.
Gamma-hydroxybutyrate has no drug-drug interactions with beta blockers, caffeine, or nicotine.

[jrubin]

Thank you!

[ktidd]

Always glad to help...