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Exam (elaborations)

Thyroid/Parathyroid

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Exam of 8 pages for the course Thyroid/Parathyroid at Thyroid/Parathyroid (Thyroid/Parathyroid)

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The nurse visits the home of a client recovering from a thyroidectomy. Which finding(s) indicates to the
nurse that the client is developing hypocalcemia? Select all that apply.



A. Hypoactive bowel sounds

B. New onset of dysphagia

C. Report of stiff hands and feet

D. Numbness and tingling of the hands

E. +3 pitting edema of the lower extremities - ANS_B. New onset of dysphagia

C. Report of stiff hands and feet

D. Numbness and tingling of the hands




During thyroid removal surgery, the risk of removing the parathyroid glands is great. When these glands
are removed, hypoparathyroidism occurs which leads to the development of hypocalcemia. Clinical
manifestations of hypocalcemia include dysphagia, stiffness of the hands and feet, and numbness and
tingling of the hands. Hypoactive bowel sounds and pitting edema are not manifestations of
hypocalcemia.



Thyroid storm is a severe form of hyperthyroidism that can be fatal if not treated. Medical management
includes pharmacotherapy. Which of the following drugs have proved helpful? Select all that apply.



A. Hydrocortisone

B. Acetaminophen

C. Salicylates

, D. Methimazole

E. Iodine - ANS_A. Hydrocortisone

B. Acetaminophen

D. Methimazole

E. Iodine



Salicylates (i.e., aspirin) are contradicted because they displace thyroid hormone from binding to
proteins and make hypermetabolism worse.



A nurse is caring for a client with suspected hyperparathyroidism. Which condition may contribute to
hyperparathyroidism?



A. Renal failure

B. Thyroidectomy

C. Decreased serum calcium level

D. Steroid use - ANS_A. Renal failure



Kidney damage can result from the precipitation of calcium phosphate in the renal pelvis and
parenchyma, which causes renal calculi (kidney stones), obstruction, pyelonephritis, and kidney injury.
Parathyroid hormone release increases, causing hyperparathyroidism. Serum calcium level may rise as a
result of hyperparathyroidism. Thyroidectomy may lead to hypoparathyroidism if the parathyroid is also
removed during surgery. Steroid use causes calcium to leave bone, suppressing parathyroid hormone.



When caring for a client who's being treated for hyperthyroidism, the nurse should:



A. provide extra blankets and clothing to keep the client warm.

B. monitor the client for signs of restlessness, sweating, and excessive weight C. loss during thyroid
replacement therapy.

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