Author Question: A patient is being admitted to the unit from the emergency department. The nurse calls in the report ... (Read 98 times)

jrubin · **on:** Jul 23, 2018

A patient is being admitted to the unit from the emergency department. The nurse calls in the report on the patient to the receiving nurse and conveys the assessment findings:

complaints of restlessness, agitation, and tremor; vital signs are temperature of 105 F, pulse 122, blood pressure of 90/47, and respiration of 28. The nurse suspects that the patient is showing signs and symptoms of ___________ and anticipates the administration of multiple drugs, including ______________ to suppress thyroid hormone release.
a. thyroid storm; potassium iodide or a strong iodine solution
b. toxic nodular goiter; a beta blocker
c. Hashimoto's thyroiditis; propylthiouracil
d. thyrotoxic crisis; propylthiouracil

Question 2

The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient is reluctant to take the prescribed therapy. The nurse should educate this patient that

a. neuropsychologic deficits in the fetus may result if the condition is not treated.
b. no danger to the fetus exists until the third trimester, therefore the patient has time to make the decision.
c. treatment is required only if the mother is experiencing symptoms.
d. hypothyroidism is a normal effect of pregnancy and usually is of no consequence.

bubulittle310@msn.cn · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
The signs and symptoms displayed are consistent with thyroid storm, also known as thyrotoxic crisis. The medication used to suppress thyroid hormone release is potassium iodide or a strong iodine solution.
Toxic nodular goiter is similar to Graves' disease in signs and symptoms except for the absence of exophthalmos; the beta blocker might be given to reduce the heart rate and the tremors which are common with hyperthyroidism.
Hashimoto's thyroiditis is a chronic autoimmune disease that is a type of hypothyroidism.
Thyrotoxic crisis is not synonymous with hyperthyroidism and is managed differently, depending on its etiology. Propylthiouracil is used to suppress thyroid hormone synthesis and peripheral conversion of T4 to T3.

Answer to Question 2

ANS: A
Maternal hypothyroidism can result in permanent neuropsychologic deficits in the child.
The greatest danger to the fetus occurs in the first trimester, because the fetus is entirely dependent on the mother; the thyroid does not fully develop until the second trimester. Early identification is essential.
Symptoms often are vague. Treatment should begin as soon as possible, or mental retardation and other developmental problems may occur.
Hypothyroidism is not a normal effect of pregnancy and is a serious condition that can affect both mother and fetus.