NR 464 EVALUATION EXAM 2025 QUESTIONS WITH
ANSWERS GUARANTEE A+
✔✔***POST OP CARE FOR SUBTOTAL THYROIDECTOMY: 6/10 - ✔✔Assess q2h
during first 24 hours for s/s of hemorrhage or tracheal compression
Semi fowler's position - reduce edema
Support head with pillows
Avoid neck flexion and tension on suture line
✔✔!***POST OP CARE FOR SUBTOTAL THYROIDECTOMY: 10/10 - ✔✔Monitor VS
and Ca+ levels
S/S of hypocalcemia
-Difficulty speaking
-Trousseau's (BP and hand jerk)
-Chvostek's
Analgesics
Ambulation
Psychosocial support
✔✔Discharge teaching in thyroidectomy (4/7) - ✔✔Monitor hormone balance
periodically
↓ caloric intake
Adequate iodine intake
Regular exercise
✔✔Discharge teaching in thyroidectomy (7/7) - ✔✔Avoid ↑ environmental temp
Regular follow up
Complete thyroidectomy
-S/S of hypothyroidism
-Need for lifelong thyroid hormone replacement
✔✔Hypothyroidism:
What is it?
,Causes (6) - ✔✔Insufficient thyroid hormone
Primary or secondary
Iodine deficiency
Gland atrophy
Treatment for hyperthyroidism
Drugs
Cretinism if occurs in infancy
✔✔S/S of hypothyroidism (8/16) - ✔✔Fatigue
Forgetfulness
Irritability
Can't concentrate
Thinning hair/hair loss (body hair 2)
Dry patchy skin
Cold intolerance
↑ cholesterol
✔✔S/S of hypothyroidism (16/16) - ✔✔Puffy eyes/preorbital edema
Swelling (goiter)
Hoarseness voice/Difficulty swallowing
Persistent dry or sore throat
Bradycardia
Menstrual irregularities/heavy period and infertility
Constipation
Muscle weakness/cramps
,✔✔Myxedema: What is happening? (2) - ✔✔Due to accumulation of hydrophilic
mucopolysaccharides in the dermis and other tissues
Can develop myxedema coma
✔✔Diagnostic studies for hypothyroidism (3) - ✔✔Hx and PE
TSH & Free T4
Thyroid antibodies
✔✔Nursing care for hypothyroidism (4) - ✔✔Skin care:
-Moisturize frequently to prevent skin breakdown
-Positioning
VS, weight, I&O, edema
CV response to hormone
-If they have HR problems, can't give thyroid supplement
Energy level
-Look at neuro status when continuing tx
✔✔Thyroid hormone therapy: Levothyroxine (Synthroid)
When is it taken?
IV for what? How much?
What do you need to evaluate?
WHAT IS IMPORTANT ABOUT THIS - ✔✔First thing in morning on an empty stomach
for absorption
IV for myxedema coma, begin dosage low and increase.
TSH levels
LIFE LONG TREATMENT
✔✔Discharge teaching for hypothyroidism (6/11) - ✔✔Written instructions
Lifelong therapy
****Synthroid taking in morning - s/s ? - tachycardia
, S/S of hypothyroidism and hyperthyroidism
Regular follow up care
DON'T switch brands
✔✔Discharge teaching for hypothyroidism (11/11) - ✔✔Skin breakdown prevention
Warm environment
Avoid sedatives or use lowest dose
Minimize constipation
Avoid enemas
✔✔Diabetes Insipidus: What is happening? (2)
3 types of DI - ✔✔Deficiency of ADH
Fluid and electrolyte imbalance = because decreased water reabsorption = lose a lot of
water
Central (neurogenic) DI
-Lesion of pituitary
Nephrogenic DI
-Kidney non-responsive
Dispogenic DI
-Excessive water intake
✔✔S/S of DI (3)
Diagnostic studies (2) - ✔✔Polydipsia
Polyuria (Excrete 2-3L of dilute urine with a low SG)
Elevated serum osmolality
-Serum labs
-Water deprivation test
✔✔Collaborative care for DI (3) - ✔✔Treat cause
ANSWERS GUARANTEE A+
✔✔***POST OP CARE FOR SUBTOTAL THYROIDECTOMY: 6/10 - ✔✔Assess q2h
during first 24 hours for s/s of hemorrhage or tracheal compression
Semi fowler's position - reduce edema
Support head with pillows
Avoid neck flexion and tension on suture line
✔✔!***POST OP CARE FOR SUBTOTAL THYROIDECTOMY: 10/10 - ✔✔Monitor VS
and Ca+ levels
S/S of hypocalcemia
-Difficulty speaking
-Trousseau's (BP and hand jerk)
-Chvostek's
Analgesics
Ambulation
Psychosocial support
✔✔Discharge teaching in thyroidectomy (4/7) - ✔✔Monitor hormone balance
periodically
↓ caloric intake
Adequate iodine intake
Regular exercise
✔✔Discharge teaching in thyroidectomy (7/7) - ✔✔Avoid ↑ environmental temp
Regular follow up
Complete thyroidectomy
-S/S of hypothyroidism
-Need for lifelong thyroid hormone replacement
✔✔Hypothyroidism:
What is it?
,Causes (6) - ✔✔Insufficient thyroid hormone
Primary or secondary
Iodine deficiency
Gland atrophy
Treatment for hyperthyroidism
Drugs
Cretinism if occurs in infancy
✔✔S/S of hypothyroidism (8/16) - ✔✔Fatigue
Forgetfulness
Irritability
Can't concentrate
Thinning hair/hair loss (body hair 2)
Dry patchy skin
Cold intolerance
↑ cholesterol
✔✔S/S of hypothyroidism (16/16) - ✔✔Puffy eyes/preorbital edema
Swelling (goiter)
Hoarseness voice/Difficulty swallowing
Persistent dry or sore throat
Bradycardia
Menstrual irregularities/heavy period and infertility
Constipation
Muscle weakness/cramps
,✔✔Myxedema: What is happening? (2) - ✔✔Due to accumulation of hydrophilic
mucopolysaccharides in the dermis and other tissues
Can develop myxedema coma
✔✔Diagnostic studies for hypothyroidism (3) - ✔✔Hx and PE
TSH & Free T4
Thyroid antibodies
✔✔Nursing care for hypothyroidism (4) - ✔✔Skin care:
-Moisturize frequently to prevent skin breakdown
-Positioning
VS, weight, I&O, edema
CV response to hormone
-If they have HR problems, can't give thyroid supplement
Energy level
-Look at neuro status when continuing tx
✔✔Thyroid hormone therapy: Levothyroxine (Synthroid)
When is it taken?
IV for what? How much?
What do you need to evaluate?
WHAT IS IMPORTANT ABOUT THIS - ✔✔First thing in morning on an empty stomach
for absorption
IV for myxedema coma, begin dosage low and increase.
TSH levels
LIFE LONG TREATMENT
✔✔Discharge teaching for hypothyroidism (6/11) - ✔✔Written instructions
Lifelong therapy
****Synthroid taking in morning - s/s ? - tachycardia
, S/S of hypothyroidism and hyperthyroidism
Regular follow up care
DON'T switch brands
✔✔Discharge teaching for hypothyroidism (11/11) - ✔✔Skin breakdown prevention
Warm environment
Avoid sedatives or use lowest dose
Minimize constipation
Avoid enemas
✔✔Diabetes Insipidus: What is happening? (2)
3 types of DI - ✔✔Deficiency of ADH
Fluid and electrolyte imbalance = because decreased water reabsorption = lose a lot of
water
Central (neurogenic) DI
-Lesion of pituitary
Nephrogenic DI
-Kidney non-responsive
Dispogenic DI
-Excessive water intake
✔✔S/S of DI (3)
Diagnostic studies (2) - ✔✔Polydipsia
Polyuria (Excrete 2-3L of dilute urine with a low SG)
Elevated serum osmolality
-Serum labs
-Water deprivation test
✔✔Collaborative care for DI (3) - ✔✔Treat cause
