A patient with hypothyroidism is treated with levothyroxine (Synthroid). What should the nurse include when teaching the patient about this therapy?

Correct Answer: B

Rationale: The correct answer is B: Provide written instruction for all information related to the drug therapy. Explanation: Providing written instructions is crucial when teaching a patient about levothyroxine therapy for hypothyroidism. Written materials offer a permanent reference that the patient can revisit as needed, ensuring comprehension and adherence to the treatment plan. Since managing hypothyroidism with levothyroxine involves a delicate balance of hormone levels, clear and comprehensive written instructions help the patient understand dosing, timing, potential side effects, and the importance of adherence to the prescribed regimen. Why the other options are incorrect: A) Explaining that alternate-day dosage may be used if side effects occur is not the most appropriate response in this scenario. Adjusting dosage should be done under the guidance of a healthcare provider, and patients should not self-adjust their medication regimen. C) Assuring the patient that a return to normal function will occur with replacement therapy oversimplifies the process. Achieving hormonal balance with levothyroxine therapy is a gradual process that requires monitoring and adjustments. D) Informing the patient that the drug must be taken until the hormone balance is reestablished is partially true but lacks the specificity and detail that providing written instructions would offer. Educational context: In healthcare, patient education is a vital component of promoting adherence to treatment plans and achieving positive outcomes. By providing patients with written instructions, healthcare providers can empower them to take an active role in their care, improve medication adherence, and enhance their overall health literacy. Teaching patients about their treatment options and medications in a clear and accessible manner fosters better understanding and collaboration between healthcare providers and patients.

Correct Answer: C

Rationale: In the context of diabetes, Hyperglycemic hyperosmolar nonketotic coma (HHNK) is a serious complication characterized by extremely high blood sugar levels without the presence of ketones. Polyuria, which is excessive urination, is a hallmark symptom of HHNK. A) Hypertension is not a typical symptom of HHNK. While diabetes can lead to hypertension over time, it is not a direct symptom of HHNK. B) Bradycardia, or a slow heart rate, is also not a common symptom of HHNK. In fact, the body's response to the high blood sugar levels in HHNK often leads to dehydration and increased heart rate (tachycardia) rather than bradycardia. D) Kussmaul respirations are rapid, deep, and labored breathing patterns that are typically seen in diabetic ketoacidosis (DKA), not in HHNK. In HHNK, the body tries to compensate for the high blood sugar levels by increasing urine production, leading to dehydration and electrolyte imbalances. Understanding the specific symptoms associated with different diabetic complications is crucial for healthcare professionals to provide timely and appropriate interventions. Educating students on these distinctions can help them develop critical thinking skills in assessing and managing patients with diabetes-related complications.

Correct Answer: B

Rationale: In the scenario of a patient who has just undergone a subtotal thyroidectomy, monitoring for signs of hemorrhage and shock (Option B) during the first 12 hours postoperatively is crucial. This is because post-thyroidectomy hemorrhage is a significant complication that can lead to airway compromise, hypovolemic shock, and potential death. Monitoring for early signs such as neck swelling, difficulty breathing, tachycardia, and hypotension allows for prompt intervention and prevention of serious consequences. In contrast, the other options are not priorities during the immediate postoperative period after a thyroidectomy. Instructing the patient to avoid moving the head (Option A) is not as critical as monitoring for hemorrhage and shock. Administering medications to reduce thyroid hormone levels (Option C) and preparing the patient for thyroid replacement therapy (Option D) are important aspects of long-term care but are not immediate concerns in the first 12 hours postoperatively. Educationally, understanding the priorities in post-thyroidectomy care is essential for nurses to provide safe and effective care to these patients. By emphasizing the importance of vigilant monitoring for complications like hemorrhage and shock, nurses can ensure early detection and intervention, ultimately improving patient outcomes and safety.

Correct Answer: D

Rationale: The correct answer is D) Hypertension, low HDL, and elevated triglycerides. In the context of metabolic syndrome, these signs and symptoms are commonly seen and are key components of the diagnostic criteria. Hypertension, or high blood pressure, is a hallmark feature of metabolic syndrome. It is a key risk factor for cardiovascular disease and is often present in individuals with this condition. Low HDL (high-density lipoprotein) levels and elevated triglycerides are also typical findings in metabolic syndrome. Low HDL levels are associated with an increased risk of heart disease, while elevated triglycerides indicate abnormal lipid metabolism, which is common in metabolic syndrome. Now, let's address why the other options are incorrect: A) Weight loss, malar rash, and pharyngitis: These symptoms are not typically associated with metabolic syndrome. Weight gain or obesity is actually a common feature of metabolic syndrome. B) Hypothyroidism, podagra, and elevated fasting glucose: While elevated fasting glucose is a symptom of metabolic syndrome, hypothyroidism and podagra are not typically part of this syndrome. C) Violaceous rash, pitting peripheral edema, and palpitation: These symptoms are not specific to metabolic syndrome. Pitting peripheral edema can be seen in conditions like heart failure, while palpitations can have various causes unrelated to metabolic syndrome. Educational Context: Understanding the signs and symptoms of metabolic syndrome is crucial for healthcare professionals, especially nurses, as they play a vital role in educating and supporting patients with this condition. By recognizing these key features, nurses can provide targeted interventions to help manage and prevent complications associated with metabolic syndrome, such as cardiovascular disease and type 2 diabetes. Education on lifestyle modifications, medication management, and regular monitoring is essential in empowering patients like Alexa to take control of their health and well-being.

Correct Answer: B

Rationale: The correct answer is B) Detect the presence of cerebrospinal fluid. In a client with acromegaly who has undergone nasal surgery, detecting the presence of cerebrospinal fluid is essential because damage to the nasal cavity during the surgery can lead to leakage of cerebrospinal fluid, which can increase the risk of infection and other complications. Option A, detecting signs of increased intracranial pressure and meningitis, is incorrect because while monitoring for these conditions is important post-operatively, detecting cerebrospinal fluid leakage takes precedence due to the immediate risk it poses. Option C, detecting signs of hypoglycemia, is unrelated to the situation described and is not a priority in this context. Option D, detecting the presence of striae, is also unrelated to the post-operative care of a client with acromegaly and nasal packing. In an educational context, understanding the priority nursing actions post-operatively for specific conditions like acromegaly and nasal surgery is crucial for providing safe and effective care to patients. Nurses must be able to prioritize assessments and interventions based on the individual needs of the patient to prevent complications and promote recovery.