Author Question: Which nursing assessment of a 69-year-old patient is most important to make during initiation of ... (Read 43 times)

bobthebuilder · **on:** Jun 25, 2018

Which nursing assessment of a 69-year-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)?

a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness

Question 2

A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving and expected to be discharged in 2 days. Which teaching strategy will be best for the nurse to use?

a. Provide written reminders of self-care information.
b. Offer multiple options for management of therapies.
c. Ensure privacy for teaching by asking visitors to leave.
d. Delay teaching until patient discharge date is confirmed.

Sarahjh · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
In older patients, initiation of levothyroxine therapy can increase myocardial oxygen demand and cause angina or dysrhythmias. The medication also is expected to improve mental status and fluid balance and will increase metabolic rate and nutritional needs, but these changes will not result in potentially life-threatening complications.

Answer to Question 2

ANS: A
Written instructions will be helpful to the patient because initially the hypothyroid patient may be unable to remember to take medications and other aspects of self-care. Because the treatment regimen is somewhat complex, teaching should be initiated well before discharge. Family members or friends should be included in teaching because the hypothyroid patient is likely to forget some aspects of the treatment plan. A simpler regimen will be easier to understand until the patient is euthyroid.