Question 1

Why should pregnant patients who have hypothyroidism continue to take thyroid replacement drugs throughout pregnancy?

Accepted Answer

The thyroid gland secretes hormones that are necessary for life.Not taking the drug can lead to problems with the pregnancy and with the fetus.The pregnant woman often needs a higher dose of the drug.

Question 2

A patient with hyperthyroidism is in the hospital waiting for surgery to remove the thyroid gland.This patient has all of the following conditions.For which condition does the nurse notify the prescriber immediately?

Accepted Answer

A complication of severe hyperthyroidism is thyroid crisis (also known as thyroid storm).Symptoms include fever,dangerously high blood pressure,and a rapid,irregular heart beat.The symptoms can develop quickly,and if not treated,this problem can lead to seizures,heart failure,and death.An elevation in temperature may be an indication of impending thyroid crisis and requires immediate attention.

Question 3

Why does a patient who is taking drugs for thyroid suppression continue to have symptoms of hyperthyroidism for 3 weeks (or longer)after drug therapy is started?

Accepted Answer

Thyroid-suppressing drugs enter the thyroid gland and combine with the enzyme responsible for connecting iodine (iodide)with tyrosine to make active thyroid hormones,preventing further thyroid hormone synthesis.These drugs do not affect the hormones already formed and stored in the thyroid gland,so it may take as long as 3 or 4 weeks for the person to use up all the thyroid hormones made before the drug was started.Until that time,the person continues to have symptoms of hyperthyroidism.

Question 4

Which mineral is critical for the thyroid to use in making thyroid hormones?

Accepted Answer

Thyroid hormones (TH)are made from the amino acid tyrosine and the mineral iodine.For the thyroid gland to make correct amounts of TH,the diet must contain enough protein and iodine.

Question 5

Laboratory blood tests show that a patient has a T3 level of 190 ng/dL.How does the nurse interpret this finding?

Accepted Answer

The normal level for T3 (triiodothyronine)ranges between 70 and 205 ng/dL.

Question 6

A patient who is prescribed liothyronine (Cytomel)also takes warfarin (Coumadin).Which laboratory blood test result indicates to the nurse a possible drug interaction?

Accepted Answer

Liothyronine increases the effectiveness of warfarin.Warfarin's effectiveness is measured by the INR.This value should be between 1.5 and 3.0 in a patient taking warfarin.With an INR level of 4.5 the patient is at extreme risk for excessive bleeding.

Question 7

A patient who has been taking methimazole (Tapazole)for 3 weeks has all of the following laboratory blood test results.Which result does the nurse report immediately to the prescriber?

Accepted Answer

All of these blood values are abnormal; however,only the lactate dehydrogenase level is very high (four times normal).This value indicates liver impairment.Methimazole can cause liver impairment.This value must be reported immediately so that liver function can be explored and any needed changes in drug therapy made before irreversible liver damage occurs.

Question 8

Which precautions are important for the nurse to teach a patient who is taking hormone replacement therapy (HRT)to reduce menopausal discomfort?

Accepted Answer

HRT with estrogens increase the risk for clot formation that could cause venous thromboembolism,stroke,and heart attack.The risk is higher if the patient also smokes.Patients taking HRT should avoid cigarette smoking and should seek medical help immediately if chest pain or symptoms of a stroke occur.Hormones like estrogen can make breast cancers grow faster.The patient should perform monthly breast self-examinations to determine the presence of any lumps that could be cancerous.Although a yearly influenza vaccination is a good health promotion practice,HRT does not increase the risk for influenza.Oral contraceptives should not be used with HRT.There is no contraindication for drinking alcohol (in moderation)while taking HRT.

Question 9

A patient is prescribed levothyroxine 25 mcg by IV push.The drug on hand is levothyroxine sodium 100 mcg/mL.How many milliliters does the nurse administer?

Accepted Answer

Want 25 mcg per /X mL,Have 100 mcg per 1 mL; 25/100 = 0.25 F1F1F1S1F1F1F10 1 mL = 0.25 mL.

Question 10

Which assessment is most important for the nurse to perform before giving a patient who is prescribed levothyroxine (Synthroid)the first dose of the drug?

Accepted Answer

The side effects and adverse effects of thyroid hormone replacement drugs increase metabolic rate and cardiac activity.Checking heart rate and rhythm before giving the drug provides a baseline to determine whether or not the drug is working correctly or is causing an overdose effect.

Question 11

Which precaution is important for the nurse to teach an older patient who is prescribed methimazole (Tapazole)?

Accepted Answer

The older adult's resistance to infection is already lower than a younger adult's because of age-related changes that occur in the immune system.The decreased bone marrow activity caused by methimazole makes this problem worse,greatly increasing the older adult's risk for infection.

Question 12

A patient who has just been prescribed estrogen-based hormone replacement therapy (HRT)also has all of the following health problems.For which problem does the nurse check with the prescriber to determine whether the patient should take HRT?

Accepted Answer

Common side effects of menopausal HRT include breast tenderness,breakthrough bleeding,fluid retention weight gain,and acne.These occur with conjugated estrogen alone and when combined with progesterone.Fluid retention can cause or worsen hypertension.If the patient's hypertension is not well controlled,she should not be taking HRT.

Question 13

How do thyroid replacement drugs affect diabetes?

Accepted Answer

Thyroid hormone replacement drugs change the effectiveness of insulin and other drugs for diabetes,and often these drugs need to be increased to prevent high blood glucose levels (hyperglycemia).Patients with diabetes and hypothyroidism should be taught to check blood glucose levels more frequently.

Question 14

A patient with hyperthyroidism is prescribed an immediate dose of propylthiouracil (Propacil)150 mg orally.The available drug is propylthiouracil 50 milligrams per tablet.How many tablets does the nurse administer?
_____ tablets

Accepted Answer

The answer of A patient with hyperthyroidism is prescribed an...

Question 15

A patient who is prescribed propylthiouracil (Propacil)also takes warfarin (Coumadin).Which laboratory blood test result indicates to the nurse a possible drug interaction?

Accepted Answer

Propylthiouracil increases the effectiveness of warfarin.Warfarin's effectiveness is measured by the INR.This value should be between 1.5 and 3.0 in a patient taking warfarin.With an INR level of 4.5 the patient is at extreme risk for excessive bleeding.

Question 16

Which precaution is most important for the nurse to teach a patient who is newly prescribed a thyroid hormone replacement drug?

Accepted Answer

When a patient begins treatment with thyroid replacement drugs,the starting drug dosage is very low,with no attempt to bring the blood thyroid hormone level back to normal quickly.These drugs can change metabolism quickly and lead to adverse effects such as heart attack or seizure.Dosages start low and are raised very slowly (about every 3 weeks).The patient should never increase the dose unless instructed to do so by the prescriber.

Question 17

Which statement made by a patient who is taking a thyroid replacement drug indicates to the nurse that a higher dose may be needed?

Accepted Answer

When blood thyroid hormone levels are insufficient to maintain a normal metabolic rate,symptoms of hypothyroidism return.Patients usually feel tired or weak and often report an increase in time spent sleeping,sometimes up to 14 to 16 hours per day.

Question 18

A patient with hypothyroidism as a result of Hashimoto's thyroiditis asks how long thyroid replacement drugs will need to be taken.What is the nurse's best response?

Accepted Answer

Hashimoto's thyroiditis results in a permanent loss of thyroid function.Without continuous thyroid replacement drugs,the patient's metabolism would eventually stop and death would occur.

Question 19

Which symptom of hyperthyroidism occurs only with the Graves' disease form of the problem?

Accepted Answer

Exophthalmos is a bulging or protrusion of the eyes,causing blurred vision.This problem is unique to hyperthyroidism because the disorder causes tissue behind the eye to swell,pushing the eyeball forward.

Question 20

A patient who has been taking levothyroxine (Synthroid)for 2 months has all of the following conditions.Which condition indicates to the nurse that the drug therapy is effective?

Accepted Answer

Hypothyroidism decreases GI motility significantly.One of the parameters that can be used to determine if changes in the dose of a thyroid replacement drug should be adjusted is the frequency of bowel movements.A bowel movement every day is a strong indication that the dose of thyroid replacement hormone is adequate.

Quiz 24: Drugs for Endocrine Problems

Why should pregnant patients who have hypothyroidism continue to take thyroid replacement drugs throughout pregnancy?

A patient with hyperthyroidism is in the hospital waiting for surgery to remove the thyroid gland.This patient has all of the following conditions.For which condition does the nurse notify the prescriber immediately?

Why does a patient who is taking drugs for thyroid suppression continue to have symptoms of hyperthyroidism for 3 weeks (or longer) after drug therapy is started?

Which mineral is critical for the thyroid to use in making thyroid hormones?

Laboratory blood tests show that a patient has a T3 level of 190 ng/dL.How does the nurse interpret this finding?

A patient who is prescribed liothyronine (Cytomel) also takes warfarin (Coumadin) .Which laboratory blood test result indicates to the nurse a possible drug interaction?

A patient who has been taking methimazole (Tapazole) for 3 weeks has all of the following laboratory blood test results.Which result does the nurse report immediately to the prescriber?

Which precautions are important for the nurse to teach a patient who is taking hormone replacement therapy (HRT) to reduce menopausal discomfort?

A patient is prescribed levothyroxine 25 mcg by IV push.The drug on hand is levothyroxine sodium 100 mcg/mL.How many milliliters does the nurse administer?

Which assessment is most important for the nurse to perform before giving a patient who is prescribed levothyroxine (Synthroid) the first dose of the drug?

Which precaution is important for the nurse to teach an older patient who is prescribed methimazole (Tapazole) ?

A patient who has just been prescribed estrogen-based hormone replacement therapy (HRT) also has all of the following health problems.For which problem does the nurse check with the prescriber to determine whether the patient should take HRT?

How do thyroid replacement drugs affect diabetes?

A patient with hyperthyroidism is prescribed an immediate dose of propylthiouracil (Propacil)150 mg orally.The available drug is propylthiouracil 50 milligrams per tablet.How many tablets does the nurse administer? _____ tablets

A patient who is prescribed propylthiouracil (Propacil) also takes warfarin (Coumadin) .Which laboratory blood test result indicates to the nurse a possible drug interaction?

Which precaution is most important for the nurse to teach a patient who is newly prescribed a thyroid hormone replacement drug?

Which statement made by a patient who is taking a thyroid replacement drug indicates to the nurse that a higher dose may be needed?

A patient with hypothyroidism as a result of Hashimoto's thyroiditis asks how long thyroid replacement drugs will need to be taken.What is the nurse's best response?

Which symptom of hyperthyroidism occurs only with the Graves' disease form of the problem?

A patient who has been taking levothyroxine (Synthroid) for 2 months has all of the following conditions.Which condition indicates to the nurse that the drug therapy is effective?