©Themoon EXAM SOLUTIONS
26/11/2024 10:59AM
NR565 week 5 Exam Questions and
Answers
Signs and symptoms of hypothyroidism and hyperthyroidism - Answers✓✓Hypothyroidism:
Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought process, Weight gain
(5-10 lbs./2.25-4.5 kg) Constipation, Menorrhagia, Cold intolerance: Cold all the time
Hyperthyroidism (aka graves disease):
Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg) Diarrhea, loose,
frequent stools, Oligomenorrhea, Heat intolerance: Hot all the time
pg. 418-419
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications?
Know drug classes and examples of those drug classes. - Answers✓✓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.
pg. 419
Monitoring needs and intervals for thyroid medications. - Answers✓✓levothyroxine-
Monitoring: 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.
, ©Themoon EXAM SOLUTIONS
26/11/2024 10:59AM
Methimazole-Monitoring: Check CBC with differential if signs or symptoms of infection.
Check LFTs if signs or symptoms of liver dysfunction.
Propylthiouracil (PTU)- Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid.
- Propylthiouracil (PTU) carries a risk for liver toxicity. Although rare, the FDA recommends
against using PTU as a first-line treatment due to potential for hepatic toxicity. -
Answers✓✓Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid. pg 421
- Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - Answers✓✓Maternal hypothyroidism can result in permanent
neuropsychological deficits in the child.
can decrease IQ and other aspects of neuropsychological function in the child.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism must be diagnosed and
treated very early.
some authorities currently recommend routine screening for hypothyroidism as soon as
pregnancy is confirmed. If hypothyroidism is diagnosed, replacement therapy should begin
immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
, ©Themoon EXAM SOLUTIONS
26/11/2024 10:59AM
When women taking thyroid supplements become pregnant, dosage requirements usually
increase—often by as much as 50%. The need for increased dosage begins between weeks 4
and 8 of gestation, levels off at approximately week 16, and then remains steady until
parturition.
pg. 418
- Patient teaching for thyroid medications. - Answers✓✓:levothyroxine:
should be taken on an empty stomach in the morning, at least 30 to 60 minutes before breakfast.
Inform patients about the symptoms of thyrotoxicosis and instruct them to notify the prescriber
if these develop (Sweating, irritability, weight loss, tachycardia)Instruct patients to separate
administration of levothyroxine and these drugs by 4 hours
Overdose may cause thyrotoxicosis. Symptoms include tachycardia, angina, tremor,
nervousness, insomnia, sweating, and heat intolerance.
methamizole:
Agranulocytosis: Inform patients about early signs of agranulocytosis, including fever or sore
throat. If follow-up blood tests reveal leukopenia, methimazole should be stopped.
Hypothyroidism: Methimazole may cause excessive reductions in thyroid hormone synthesis. If
signs of hypothyroidism develop or if plasma levels of T3 and T4 become subnormal, dosage
should be reduced.
Radioactive Iodine:
Inform patients about symptoms of iodism, including brassy taste, burning sensations in the
mouth, and soreness of gums and teeth. Iodine can also cause corrosive injury to the GI tract.
Instruct patients to notify the prescriber if severe abdominal distress develops.
26/11/2024 10:59AM
NR565 week 5 Exam Questions and
Answers
Signs and symptoms of hypothyroidism and hyperthyroidism - Answers✓✓Hypothyroidism:
Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought process, Weight gain
(5-10 lbs./2.25-4.5 kg) Constipation, Menorrhagia, Cold intolerance: Cold all the time
Hyperthyroidism (aka graves disease):
Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg) Diarrhea, loose,
frequent stools, Oligomenorrhea, Heat intolerance: Hot all the time
pg. 418-419
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications?
Know drug classes and examples of those drug classes. - Answers✓✓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.
pg. 419
Monitoring needs and intervals for thyroid medications. - Answers✓✓levothyroxine-
Monitoring: 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.
, ©Themoon EXAM SOLUTIONS
26/11/2024 10:59AM
Methimazole-Monitoring: Check CBC with differential if signs or symptoms of infection.
Check LFTs if signs or symptoms of liver dysfunction.
Propylthiouracil (PTU)- Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid.
- Propylthiouracil (PTU) carries a risk for liver toxicity. Although rare, the FDA recommends
against using PTU as a first-line treatment due to potential for hepatic toxicity. -
Answers✓✓Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid. pg 421
- Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - Answers✓✓Maternal hypothyroidism can result in permanent
neuropsychological deficits in the child.
can decrease IQ and other aspects of neuropsychological function in the child.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism must be diagnosed and
treated very early.
some authorities currently recommend routine screening for hypothyroidism as soon as
pregnancy is confirmed. If hypothyroidism is diagnosed, replacement therapy should begin
immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
, ©Themoon EXAM SOLUTIONS
26/11/2024 10:59AM
When women taking thyroid supplements become pregnant, dosage requirements usually
increase—often by as much as 50%. The need for increased dosage begins between weeks 4
and 8 of gestation, levels off at approximately week 16, and then remains steady until
parturition.
pg. 418
- Patient teaching for thyroid medications. - Answers✓✓:levothyroxine:
should be taken on an empty stomach in the morning, at least 30 to 60 minutes before breakfast.
Inform patients about the symptoms of thyrotoxicosis and instruct them to notify the prescriber
if these develop (Sweating, irritability, weight loss, tachycardia)Instruct patients to separate
administration of levothyroxine and these drugs by 4 hours
Overdose may cause thyrotoxicosis. Symptoms include tachycardia, angina, tremor,
nervousness, insomnia, sweating, and heat intolerance.
methamizole:
Agranulocytosis: Inform patients about early signs of agranulocytosis, including fever or sore
throat. If follow-up blood tests reveal leukopenia, methimazole should be stopped.
Hypothyroidism: Methimazole may cause excessive reductions in thyroid hormone synthesis. If
signs of hypothyroidism develop or if plasma levels of T3 and T4 become subnormal, dosage
should be reduced.
Radioactive Iodine:
Inform patients about symptoms of iodism, including brassy taste, burning sensations in the
mouth, and soreness of gums and teeth. Iodine can also cause corrosive injury to the GI tract.
Instruct patients to notify the prescriber if severe abdominal distress develops.
