A patient presents with fatigue, weight gain, constipation, and cold intolerance. Which of the following thyroid
disorders is the patient most likely experiencing?
A. Hyperthyroidism
B. Hypothyroidism
C. Thyroid cancer
D. Thyroiditis
B. Hypothyroidism
Symptoms of hypothyroidism include "fatigue and insomnia," "weight gain is very common," "constipation and
cold intolerance are common," which align with the patient's presenting symptoms.
Hypothyroidism
Risk factors - not enough iodine, thyroidectomy, antithyroid meds
Assessment - ↓ T3 & T4, ↑ TSH, depression/fatigue, cold intolerance, dry/brittle skin, hair loss, ↓ appetite,
weight gain, myxedema (puffiness/edema of eyes), constipation, ↓ BP & HR
Meds - levothyroxine (Synthroid)
Myxedema coma
,A patient with hyperthyroidism reports experiencing excessive sweating and heat intolerance. Which of the
following is the most likely underlying cause of these symptoms?
A. Toxic multinodular goiter
B. Graves' disease or thyrotoxicosis
C. Impaired heat-loss mechanisms in the hypothalamus
D. Hereditary condition of uncontrolled heat production
B. Graves' disease or thyrotoxicosis
Symptoms of Graves' disease or thyrotoxicosis, the most common type of hyperthyroidism, include excessive
perspiration (hyperhidrosis), heat intolerance, nervousness, irritability.
Hyperthyroidism
Risk factors - too much iodine, toxic nodular goiter (DO NOT PALPATE), thyroid replacement meds
Assessment - lots of energy, enlarged thyroid gland, weight loss, ↑ appetite, diarrhea, heat intolerance,
tachycardia, ↑ BP, diaphoresis, nervousness, insomnia, T3 & T4 ↑, TSH ↓, exophthalmos (encourage lubricant
eye drops)
Meds - iodine (Lugol's solution), beta-blockers (↓ HR & BP), antithyroid meds: methimazole, propylthiouracil
(PTU)
Treatment - radioactive iodine therapy, thyroidectomy
Thyroid storm S&S - fever, tachycardia, agitation, HTN
,A patient has been prescribed eye drops following eye surgery. Which of the following instructions should the
nurse provide regarding proper administration of the eye drops?
A. Tilt the head back and instill the drops directly into the eye B. Wait 5 to 10 minutes between instillation of
different eye drop medications
C. Use the same bottle of eye drops for both eyes
D. Discard any remaining eye drops after the prescribed course is completed
B. Wait 5 to 10 minutes between instillation of different eye drop medications
When more than one drop is prescribed, teach the patient to wait 5 to 10 minutes between drug instillations to
prevent one drug from diluting another drug.
Also do not touch the tip of the dropper to your eye, administer drops in conjunctival sac (NOT in the lacrimal
duct - can cause systemic absorption), DO NOT RUB EYE
, A patient with a pulmonary embolism (PE) presents with cyanosis and hypotension. Which of the following is
the most likely cause of these symptoms?
A. Decreased tissue perfusion
B. Increased pulmonary blood flow
C. Improved gas exchange
D. Right ventricular hypertrophy
A. Decreased tissue perfusion
Cardiac symptoms related to decreased tissue perfusion include cyanosis hypotension. Systemic hypotension
results from acute pulmonary hypertension and reduced forward blood flow.
Implement O2 therapy, monitor O2 sat, severe hypoxemia may require mechanical ventilation
Administer anticoagulants as ordered to improve tissue perfusion - monitor for bleeding
Document increasing dyspnea, dysrhythmias, distended neck veins, edema
Ambulate as tolerated, elevate legs when in bed/chair
Instruct patient on wearing knee/thigh high compression stockings long-term to prevent venous insufficiency
and reduce swelling
disorders is the patient most likely experiencing?
A. Hyperthyroidism
B. Hypothyroidism
C. Thyroid cancer
D. Thyroiditis
B. Hypothyroidism
Symptoms of hypothyroidism include "fatigue and insomnia," "weight gain is very common," "constipation and
cold intolerance are common," which align with the patient's presenting symptoms.
Hypothyroidism
Risk factors - not enough iodine, thyroidectomy, antithyroid meds
Assessment - ↓ T3 & T4, ↑ TSH, depression/fatigue, cold intolerance, dry/brittle skin, hair loss, ↓ appetite,
weight gain, myxedema (puffiness/edema of eyes), constipation, ↓ BP & HR
Meds - levothyroxine (Synthroid)
Myxedema coma
,A patient with hyperthyroidism reports experiencing excessive sweating and heat intolerance. Which of the
following is the most likely underlying cause of these symptoms?
A. Toxic multinodular goiter
B. Graves' disease or thyrotoxicosis
C. Impaired heat-loss mechanisms in the hypothalamus
D. Hereditary condition of uncontrolled heat production
B. Graves' disease or thyrotoxicosis
Symptoms of Graves' disease or thyrotoxicosis, the most common type of hyperthyroidism, include excessive
perspiration (hyperhidrosis), heat intolerance, nervousness, irritability.
Hyperthyroidism
Risk factors - too much iodine, toxic nodular goiter (DO NOT PALPATE), thyroid replacement meds
Assessment - lots of energy, enlarged thyroid gland, weight loss, ↑ appetite, diarrhea, heat intolerance,
tachycardia, ↑ BP, diaphoresis, nervousness, insomnia, T3 & T4 ↑, TSH ↓, exophthalmos (encourage lubricant
eye drops)
Meds - iodine (Lugol's solution), beta-blockers (↓ HR & BP), antithyroid meds: methimazole, propylthiouracil
(PTU)
Treatment - radioactive iodine therapy, thyroidectomy
Thyroid storm S&S - fever, tachycardia, agitation, HTN
,A patient has been prescribed eye drops following eye surgery. Which of the following instructions should the
nurse provide regarding proper administration of the eye drops?
A. Tilt the head back and instill the drops directly into the eye B. Wait 5 to 10 minutes between instillation of
different eye drop medications
C. Use the same bottle of eye drops for both eyes
D. Discard any remaining eye drops after the prescribed course is completed
B. Wait 5 to 10 minutes between instillation of different eye drop medications
When more than one drop is prescribed, teach the patient to wait 5 to 10 minutes between drug instillations to
prevent one drug from diluting another drug.
Also do not touch the tip of the dropper to your eye, administer drops in conjunctival sac (NOT in the lacrimal
duct - can cause systemic absorption), DO NOT RUB EYE
, A patient with a pulmonary embolism (PE) presents with cyanosis and hypotension. Which of the following is
the most likely cause of these symptoms?
A. Decreased tissue perfusion
B. Increased pulmonary blood flow
C. Improved gas exchange
D. Right ventricular hypertrophy
A. Decreased tissue perfusion
Cardiac symptoms related to decreased tissue perfusion include cyanosis hypotension. Systemic hypotension
results from acute pulmonary hypertension and reduced forward blood flow.
Implement O2 therapy, monitor O2 sat, severe hypoxemia may require mechanical ventilation
Administer anticoagulants as ordered to improve tissue perfusion - monitor for bleeding
Document increasing dyspnea, dysrhythmias, distended neck veins, edema
Ambulate as tolerated, elevate legs when in bed/chair
Instruct patient on wearing knee/thigh high compression stockings long-term to prevent venous insufficiency
and reduce swelling
