What is an appropriate nursing intervention for the patient with hyperparathyroidism?

Correct Answer: B

Rationale: In the context of hyperparathyroidism, the correct nursing intervention of increasing fluid intake to 3000 to 4000 mL daily is crucial for several reasons. Hyperparathyroidism leads to increased levels of parathyroid hormone, which can result in hypercalcemia. Increasing fluid intake helps to prevent kidney stone formation, a common complication of hypercalcemia, by promoting urinary calcium excretion. Option A, padding side rails as a seizure precaution, is unrelated to the management of hyperparathyroidism. Seizures are not a typical manifestation of this condition. Option C, maintaining bed rest to prevent pathologic fractures, is not the best intervention for hyperparathyroidism. While bone resorption can lead to weakened bones and an increased risk of fractures in this condition, promoting bed rest can lead to further bone loss. Option D, monitoring the patient for Trousseau's and Chvostek's signs, is more indicative of hypocalcemia, not hypercalcemia associated with hyperparathyroidism. These signs are related to low calcium levels, not high levels seen in hyperparathyroidism. In an educational context, understanding the rationale behind the correct intervention emphasizes the importance of managing fluid intake to prevent complications associated with hypercalcemia in patients with hyperparathyroidism. It also highlights the need for nurses to have a strong foundation in pathophysiology to provide effective and evidence-based care for patients with endocrine disorders.

Correct Answer: C

Rationale: In the scenario of Mr. Conrad recovering from diabetic ketoacidosis (DKA), an expected outcome to evaluate the effectiveness of treatment is increasing responsiveness. This is because improving responsiveness indicates a positive response to treatment, with Mr. Conrad becoming more alert and responsive as his condition stabilizes. Option A, thirst, is not the expected outcome as excessive thirst is a common symptom of DKA due to dehydration and high blood sugar levels. Decreased urine output (Option B) is also not the expected outcome as increased urine output is a common symptom of DKA. An elevated hematocrit level (Option D) is not the expected outcome as DKA typically leads to hemoconcentration and elevated hematocrit due to dehydration. Educationally, understanding the expected outcomes of treating DKA is crucial for healthcare professionals to monitor and assess the effectiveness of interventions. Increasing responsiveness indicates neurological improvement and overall better physiological functioning, providing valuable insights into the patient's progress and response to treatment. This knowledge helps in optimizing patient care and making informed decisions in managing DKA and similar conditions.

Correct Answer: D

Rationale: The correct answer is D) Assess the surgical site for signs of bleeding or hematoma formation. Rationale: After a thyroidectomy, sore throat and difficulty swallowing can indicate potential complications such as bleeding or hematoma formation, which can compromise the patient's airway and require immediate intervention. Assessing the surgical site is crucial to identify any signs of bleeding or hematoma early on. This action is essential for the nurse to ensure prompt detection and management of any postoperative complications, preventing further harm to the patient. Why the others are wrong: A) Administering analgesics and reassuring the patient may provide temporary relief but does not address the underlying issue of potential bleeding or hematoma. B) Calling the surgeon immediately is important in some situations, but the nurse should first assess the patient's condition to provide accurate information to the surgeon. C) Deep breathing and coughing exercises are not appropriate in this scenario as they do not address the specific concerns related to sore throat and difficulty swallowing post-thyroidectomy. Educational context: This question highlights the importance of postoperative assessment and early recognition of complications following a thyroidectomy. Nurses need to be vigilant in monitoring patients for signs of bleeding or hematoma formation, as prompt intervention can be life-saving. Understanding the potential complications of thyroidectomy and knowing how to respond appropriately are critical skills for nurses caring for patients undergoing this procedure.

Correct Answer: A

Rationale: In this question, the correct answer is A) Fatigue and cold intolerance. This is because hypothyroidism is characterized by an underactive thyroid gland, leading to a decrease in metabolism. Fatigue is a common symptom due to the decreased energy production at the cellular level, and cold intolerance can occur as metabolism plays a role in regulating body temperature. Option B) Weight loss and hyperglycemia is incorrect because hypothyroidism typically leads to weight gain rather than weight loss, and hyperglycemia is more commonly associated with conditions like diabetes. Option C) Polydipsia and polyphagia are symptoms of diabetes, not hypothyroidism. Polydipsia refers to excessive thirst, and polyphagia refers to excessive hunger, both of which are related to the effects of high blood sugar levels in diabetes. Option D) Tachycardia and diarrhea are more indicative of hyperthyroidism, where the thyroid gland is overactive, leading to symptoms such as rapid heartbeat and increased bowel movements. Educationally, understanding the signs and symptoms of hypothyroidism is crucial for healthcare providers to accurately diagnose and treat patients. By knowing the characteristic features of this condition, appropriate interventions can be implemented to improve patient outcomes. This knowledge also helps in differentiating hypothyroidism from other endocrine disorders with overlapping symptoms, leading to more targeted and effective treatment approaches.

Correct Answer: C

Rationale: The correct answer is C) Pulmonary congestion. Explanation: Fluid overload is a condition characterized by an excess of fluid in the body, often due to issues with the heart, kidneys, or liver. Pulmonary congestion is a common sign of fluid overload, where fluid accumulates in the lungs leading to symptoms like shortness of breath, coughing, and crackles heard on auscultation. This occurs because the excess fluid leaks into the lungs from the congested blood vessels. Weakness (Option A) and headache (Option B) are not typical signs of fluid overload. Weakness may result from various causes such as electrolyte imbalances or anemia, while headaches can be due to migraines, tension, or other causes unrelated to fluid overload. Weight gain without edema (Option D) is a tricky distractor as it may seem related to fluid overload. However, in fluid overload, weight gain is usually accompanied by edema (swelling) due to the accumulation of fluid in the interstitial spaces. Weight gain without edema may point towards other reasons like increased calorie intake or decreased physical activity. Educational Context: Understanding the signs of fluid overload is crucial in healthcare, especially for nurses, physicians, and other healthcare providers. Recognizing these signs promptly can help in early intervention and appropriate management of patients with fluid overload, preventing complications such as pulmonary edema and heart failure exacerbation. This knowledge is essential in various clinical settings, including hospitals, clinics, and long-term care facilities.