NR565 COMPREHENSIVE TEST BANK
COMPLETE QUESTIONS AND ANSWERS
PRACTICE SOLUTION VERIFIED
◉ Signs and symptoms of hyperthyroidism. Answer: Heart Rate is
Rapid; Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production,
increased body temperature, intolerance to heat, and skin that is warm
and moist
Weight loss occurs if caloric intake fails to match the increase in
metabolic rate
◉ Severe hypothyroidism. Answer: Myxedema
◉ Hypothyroid Treatment. Answer: Levothyroxine is the drug of
choice for most patients who require thyroid hormone replacement.
◉ Levothyroxine (Synthroid) Therapeutic Goal. Answer: Resolution
of signs and symptoms of hypothyroidism and restoration of normal
laboratory values for serum thyroid-stimulating hormone (TSH) and
free thyroxine (T4).
,◉ Major forms of hyperthyroidism. Answer: Graves disease and toxic
nodular goiter (also known as Plummer disease).
◉ Graves Disease. Answer: Most common cause of excessive thyroid
hormone secretion
◉ What adjunctive therapy is good to prescribe to control symptoms
of hyperthyroidism other than thyroid specific medications?. Answer:
β-Blockers and nonradioactive iodine may be used as adjunctive
therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid
hormones.
◉ Monitoring needs and intervals for Levothyroxine. Answer: Check
TSH 6-8 weeks after initiating therapy and after any dosage change.
Check TSH at least once a year after serum TSH is stabilized.
◉ Hyperthyroid Treatment. Answer: thionamide drugs—methimazole
and propylthiouracil (PTU)—suppress synthesis of thyroid hormones.
◉ Methimazole Therapeutic Goal. Answer: (1) reduction of thyroid
hormone production in Graves' disease, (2) control of
hyperthyroidism until the effects of radiation on the thyroid become
manifest, (3) suppression of thyroid hormone production before
subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
,◉ Monitoring needs and intervals for Methimazole. Answer: Check
CBC with differential if signs or symptoms of infection. Check LFTs
if signs or symptoms of liver dysfunction.
◉ High Risk Patients for Methimazole. Answer: Should be avoided in
the first trimester of pregnancy.
◉ Methimazole Toxicity. Answer: Agranulocytosis is the most
dangerous toxicity.
◉ PTU High Risk Warning. Answer: Carries a risk for liver toxicity.
Although rare, the FDA recommends against using as a first-line
treatment due to potential for hepatic toxicity.
◉ Effects of maternal hypothyroidism on offspring and appropriate
patient teaching related to need for treatment.. Answer: Can cause
delay in mental development and derangement of growth. In the
absence of thyroid hormones, the child develops a large and
protruding tongue, potbelly, and dwarfish stature. Development of the
nervous system, bones, teeth, and muscles is impaired.
◉ Congenital Hypothyroidism Treatment. Answer: requires
replacement therapy with thyroid hormones. If treatment is initiated
within a few days of birth, physical and mental development will be
normal.
, replacement therapy should continue for 3 years, after which it should
be stopped for 4 weeks to determine whether thyroid deficiency is
permanent or transient.
◉ Patient Teaching for Methimazole. Answer: Tell your healthcare
providers that you are taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are
pregnant, especially in the first trimester.
If you are pregnant or become pregnant while taking this drug, call
your healthcare provider right away.
Tell your healthcare provider if you are breast-feeding to discuss risks
to the baby.
Have your baby's thyroid checked if you are using this drug and
breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this
medication but is very rare. Sore throat and fever should be reported
immediately.
◉ Patient Teaching for Levothyroxine. Answer: works best if you
take it on an empty stomach, 30 to 60 minutes before breakfast.
take the medicine at the same time each day.
◉ Ideal HbA1C goal for diabetic, non-pregnant adults. Answer: less
than 7%.
COMPLETE QUESTIONS AND ANSWERS
PRACTICE SOLUTION VERIFIED
◉ Signs and symptoms of hyperthyroidism. Answer: Heart Rate is
Rapid; Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production,
increased body temperature, intolerance to heat, and skin that is warm
and moist
Weight loss occurs if caloric intake fails to match the increase in
metabolic rate
◉ Severe hypothyroidism. Answer: Myxedema
◉ Hypothyroid Treatment. Answer: Levothyroxine is the drug of
choice for most patients who require thyroid hormone replacement.
◉ Levothyroxine (Synthroid) Therapeutic Goal. Answer: Resolution
of signs and symptoms of hypothyroidism and restoration of normal
laboratory values for serum thyroid-stimulating hormone (TSH) and
free thyroxine (T4).
,◉ Major forms of hyperthyroidism. Answer: Graves disease and toxic
nodular goiter (also known as Plummer disease).
◉ Graves Disease. Answer: Most common cause of excessive thyroid
hormone secretion
◉ What adjunctive therapy is good to prescribe to control symptoms
of hyperthyroidism other than thyroid specific medications?. Answer:
β-Blockers and nonradioactive iodine may be used as adjunctive
therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid
hormones.
◉ Monitoring needs and intervals for Levothyroxine. Answer: Check
TSH 6-8 weeks after initiating therapy and after any dosage change.
Check TSH at least once a year after serum TSH is stabilized.
◉ Hyperthyroid Treatment. Answer: thionamide drugs—methimazole
and propylthiouracil (PTU)—suppress synthesis of thyroid hormones.
◉ Methimazole Therapeutic Goal. Answer: (1) reduction of thyroid
hormone production in Graves' disease, (2) control of
hyperthyroidism until the effects of radiation on the thyroid become
manifest, (3) suppression of thyroid hormone production before
subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
,◉ Monitoring needs and intervals for Methimazole. Answer: Check
CBC with differential if signs or symptoms of infection. Check LFTs
if signs or symptoms of liver dysfunction.
◉ High Risk Patients for Methimazole. Answer: Should be avoided in
the first trimester of pregnancy.
◉ Methimazole Toxicity. Answer: Agranulocytosis is the most
dangerous toxicity.
◉ PTU High Risk Warning. Answer: Carries a risk for liver toxicity.
Although rare, the FDA recommends against using as a first-line
treatment due to potential for hepatic toxicity.
◉ Effects of maternal hypothyroidism on offspring and appropriate
patient teaching related to need for treatment.. Answer: Can cause
delay in mental development and derangement of growth. In the
absence of thyroid hormones, the child develops a large and
protruding tongue, potbelly, and dwarfish stature. Development of the
nervous system, bones, teeth, and muscles is impaired.
◉ Congenital Hypothyroidism Treatment. Answer: requires
replacement therapy with thyroid hormones. If treatment is initiated
within a few days of birth, physical and mental development will be
normal.
, replacement therapy should continue for 3 years, after which it should
be stopped for 4 weeks to determine whether thyroid deficiency is
permanent or transient.
◉ Patient Teaching for Methimazole. Answer: Tell your healthcare
providers that you are taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are
pregnant, especially in the first trimester.
If you are pregnant or become pregnant while taking this drug, call
your healthcare provider right away.
Tell your healthcare provider if you are breast-feeding to discuss risks
to the baby.
Have your baby's thyroid checked if you are using this drug and
breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this
medication but is very rare. Sore throat and fever should be reported
immediately.
◉ Patient Teaching for Levothyroxine. Answer: works best if you
take it on an empty stomach, 30 to 60 minutes before breakfast.
take the medicine at the same time each day.
◉ Ideal HbA1C goal for diabetic, non-pregnant adults. Answer: less
than 7%.
