Chapter 36: Drugs Used to Treat Thyroid Disease Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition

2. A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy? a. Decrease in the daily digoxin dosage b. Gradual increase in the daily glycoside dosage c. Inability to begin thyroid replacement therapy because of the underlying heart condition d. Increased thyroid replacement dosage ANS: B If thyroid replacement therapy is started while receiving digoxin, a gradual increase in the glycoside will also be necessary to maintain adequate therapeutic activity. Decreasing the digoxin would put the patient at risk for cardiovascular complications. The two treatments can be coordinated. The thyroid medication does not need to be increased. DIF: Cognitive Level: Comprehension REF: Page 576 OBJ: 5 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 3. Which nursing diagnosis may be identified for a patient with hyperthyroidism? a. Imbalanced nutrition: more than body requirements b. Constipation c. Disturbed sleep pattern d. Ineffective airway clearance This study source was downloaded by from CourseH on :10:36 GMT -05:00 ANS: C Hyperthyroidism is caused by an excess amount of thyroid hormones. Patients typically exhibit the following symptoms: rapid, bounding pulse (even during sleep); cardiac enlargement; palpitations; and dysrhythmias. Patients are nervous and easily agitated. Reflexes are hyperactive and the patient typically experiences insomnia. A nursing diagnosis of “Disturbed sleep pattern” would be a common problem. The patient with hyperthyroidism is likely to consume less than body requirements and is not likely to be constipated as a result of the disease. Ineffective airway clearance is not a common problem of patients with hyperthyroidism. DIF: Cognitive Level: Analysis REF: Page 572 OBJ: 4 TOP: Nursing Process Step: Diagnosis MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Clinical Judgment; Sleep; Hormonal Regulation 4. The nurse is providing instruction to a patient recently prescribed a radioactive iodine isotope. Which is the correct action of this medication? a. Stimulates the synthesis of T3 and T4 hormones b. Increases the storage of thyroxine before thyroid surgery c. Destroys hyperactive thyroid tissue d. Replaces deficient