The client with thyrotoxicosis for your nursing review.
The nurse is delivering a saturated potassium iodide solution (SSKI). The nurse should do the following:
- Drizzle the solution over the ice chips.
- Add an antacid to the solution.
- Add water, milk, or fruit juice to the solution and have the patient sip it through a straw.
- Substitute a pureed fruit or vegetable for the solution.
The correct answer is #3. To assist mask the harsh, bitter flavor of SSKI, it should be diluted well with milk, water, juice, or a fizzy beverage before administration. In addition, if taken undiluted, this medication is irritating to the mucosa. To avoid tooth discoloration, the client should consume the diluted mixture with a drinking straw. The SSKI will not be sufficiently diluted or covered by pouring the solution over ice chips. Antacids aren’t utilized to mask or lessen the flavor of SSKI. By incorporating a purée, then SSKI would come into contact with the teeth.
CN: Pharmacological and parenteral therapies; CL: Apply
Results
#1. The nurse is conducting a health examination on a 42-year-old woman who has Graves' disease. This client should be evaluated by the nurse for the following:
The most frequent kind of thyrotoxicosis, Graves’ disease, is characterized by hypermetabolism. Heat is produced by the elevated metabolic rate, which causes tachycardia and fine muscle tremors. Hypothyroidism is linked to anorexia. Weight loss, despite a healthy appetite and sufficient calorie intake, is a common symptom of hyperthyroidism. Hypothyroidism is linked to cold skin.
CL: Analyze; CN: Physiological adaptation
#2. Which of the following changes in the menstrual cycle should the nurse inquire about while performing a health history with a female client with thyrotoxicosis?
The hormonal abnormalities of thyrotoxicosis can cause a shift in the menstrual interval, reduced menstrual flow (oligomenorrhea), or even the absence of menstruation (amenorrhea). Thyrotoxicosis is characterized by oligomenorrhea in women and diminished libido and impotence in men. Menstruation pain is known as dysmenorrhea. A sign of hypothyroidism is metrorrhagia or blood loss between menstrual periods. Menorrhagia is a symptom of hypothyroidism and refers to heavy bleeding during menstrual periods.
CN: Physiological adaptation; CL: Analyze
#3. Hypothyroidism is diagnosed in a 34-year-old woman. Which of the following should the nurse check the patient for? All that apply should be selected.
Hypothyroidism causes symptoms that indicate a lack of thyroid hormone. Hypothyroidism is characterized by bradycardia, decreased energy and lethargy, memory issues, weight gain, coarse hair, constipation, and menorrhagia.
CN: Physiological adaptation; CL: Analyze
#4. A client with Graves' illness is prescribed propylthiouracil (PTU). Which of the following should the nurse instruct the client to report right away?
Leukopenia and agranulocytosis are the most serious side effects of PTU, and they usually appear within the first three months of treatment. The client should be educated to report signs and symptoms of infection, such as a sore throat and fever, to their health care practitioner as soon as possible. If a client has a sore throat and a fever, a white blood cell count and differential should be performed very once, and the medicine should be deferred until the findings are returned. PTU therapy is not linked to painful menstruation, constipation, or increased urine production.
CN: Pharmacological and parenteral therapies; CL: Synthesize
#5. "I am really irritable," a thyrotoxicosis patient tells the nurse. I'm having trouble at work because I'm quickly irritated." Which of the nurse's comments would provide the most accurate explanation for the client's behavior?
Irritability is a common symptom of thyrotoxicosis, which is characterized by high levels of circulating thyroid hormones in the body. As the client reacts to therapy, this symptom fades. Confusion is not caused by thyrotoxicosis. Although the client may be concerned about her disease, and stress may affect her mood, irritability is a typical symptom of thyrotoxicosis, and the client should be informed of this rather than blamed.
CL: Synthesize; CN: Psychosocial adaptation
#6. Thyroid hormone concentrations in the blood and thyroid-stimulating hormone (TSH) levels in the blood are tests ordered for thyrotoxicosis patients. Which of the following laboratory values suggests thyrotoxicosis?
Thyrotoxicosis is defined by elevated thyroid hormone serum concentrations and a suppressed serum TSH. TSH levels that are low or nonexistent in the blood are a good sign of thyrotoxicosis. TSH secretion is suppressed by the brain’s feedback system in response to increased levels of circulating thyroid hormones.
CL: Analyze; CN: Physiological adaptation
#7. The nurse should instruct the client how to avoid ocular discomfort caused by mild exophthalmos by doing the following:
Measures such as wearing shades to shield the eyes from corneal irritation are used to treat minor ophthalmopathy that can occur with thyrotoxicosis. Ophthalmopathy should only be treated after consulting with an ophthalmologist. The cornea will not be protected by massaging the eyes. Instead of protecting the cornea, an ophthalmic anesthetic is used to examine and possibly treat a sore eye. Because the treatment for exophthalmos is centered on protecting the cornea and optic nerve, covering the eyes with moist gauze pads is not an acceptable nursing approach to safeguard the eyes of a client with exophthalmos. Because of fluid retention, the retrobulbar connective tissues and extraocular muscle volume expand in exophthalmos. The stress level has also risen.
#8. A client with Graves' illness is given sodium iodide 131I as a kind of radioactive iodine (RAI). Which of the following nurse comments best explains how the medicine works to the client?
The thyroid follicular cells are destroyed by sodium iodide 131I, and thyroid hormones are no longer produced. RAI is frequently advised for Graves’ disease patients, particularly the elderly. A “medical thyroidectomy” is the result of the treatment. RAI is given in place of surgery rather than before it. RAI has no effect on thyroxine uptake. The elimination of thyroid follicular cells is a side effect of RAI treatment. With RAI, the production of thyroid hormones can be slowed.
#9. Following radioactive iodine (RAI) treatment in the form of sodium iodide 131I, the nurse instructs the client to:
The client must be taught the importance of thyroid hormone replacement for the rest of his or her life. The most serious side effect of RAI 131I treatment is permanent hypothyroidism. Medical monitoring and thyroid replacement should be done for the rest of your life. The client should keep an eye out for indications and symptoms of hypothyroidism rather than hyperthyroidism. It is not required to take a week off. Hypertension and tachycardia are hyperthyroidism symptoms, not hypothyroidism symptoms.
CL: Synthesize; CN: Pharmacological and parenteral therapy
#10. To treat thyrotoxicosis, a client with a significant goiter will have a subtotal thyroidectomy. Preoperatively, the client is given a saturated potassium iodide solution (SSKI). The key rationale for taking this medication is that it aids in the following:
Because it helps reduce the vascularity of the thyroid gland, SSKI is routinely used before a thyroidectomy. A thyroid gland with a lot of blood vessels is exceedingly flimsy, which can be dangerous during surgery. Thyroid hormone is depleted and vascularity is reduced as part of the client’s operation preparation. SSKI has no effect on the course of exophthalmos and has no effect on the body’s ability to store or eliminate thyroxine.
