NU272 HESI Case Study: Thyroid Disorders (week 4) with
Complete Solutions
Meet the Client - -The client works full time The client has signed the consent for the
as a high school math teacher. She is currently radioactive iodine uptake test. What are the most
working on a specialist degree, taking night important assessments for the nurse to obtain
classes at one of the local colleges. She noticed prior to the test? (Select all that apply. One,
that she is more sluggish than normal. She some, or all options may be correct.) - -Ask
doesn't have the energy for girls' nights out if the client has been taking any OTC
anymore, and for the past 4 months, she has not medications such as cough syrups? (Many OTC
attended her exercise classes. The client gained cough medications contain some iodine. There
10 pounds in the past 4 to 6 months. Her friends may not be enough to interfere with the test
say she acts depressed and encouraged her to results, but the information needs to be
see a healthcare provider (HCP) so she makes assessed.)
an appointment with the HCP.
Investigate the client's use of over the counter
(OTC) multivitamin and herbal products.(Many
The client's presenting vital signs: OTC multivitamins contain some iodine. There
Temperature: 96.0° F (36.0° C) may not be enough to interfere with the test
Pulse: 52 beats/minute results, but the information needs to be
Respirations: 18 breaths/minute assessed.)
Blood pressure: 140/80 mmHg
Given the initial history and vital signs, what Find out if the client has ever had a reaction to a
other questions should the nurse ask? (Select all bee sting.(Allergic reactions to bee stings and
that apply. One, some, or all options may be shell fish should be assessed.)
correct.) - -"Have you had any changes in
your bowel habits?"
Based on the client's history and presenting
"Do you still feel sleepy when you wake up in the symptoms, which additional diagnostic tests does
mornings despite getting a good night's sleep?" the nurse anticipate the HCP to order?(Select all
that apply. One, some, or all options may be
"Have you noticed any changes in your hair or correct.) - -CBC with differential. (The HCP
nails?" needs to rule out other possible causes of the
- client's symptoms which could include anemia or
Hypothyroidism can cause an infection.)
constipation.Hypothyroidism can cause sleep
disturbances.Hypothyroidism can cause hair loss Blood Chemistries.(Chemistries would be needed
and brittle nails. to evaluate the client's electrolyte and fluid
status.)
Diagnostic Tests - -The client is scheduled TSH and free T4. (These indicate the functioning
for a radioactive iodine uptake test. This test is or non-functioning of the thyroid gland.)
used to measure the rate of iodine uptake by the
thyroid gland. She is also scheduled for a thyroid
scan. Based on the health care provider's (HCP)
assessment and interpretation of the diagnostics,
the client is diagnosed with hypothyroidism.
Which other lab should be monitored after the
1/5
, NU272 HESI Case Study: Thyroid Disorders (week 4) with
Complete Solutions
diagnosis of hypothyroidism is confirmed? - (Hypothyroidism generally causes an individual to
-Triglycerides and cholesterol. have decreased initiative, somnolence, slowed
speech, fatigue and lethargy.)
Hypothyroidism can cause increased triglyceride
and cholesterol levels, leading to coronary Coarse dry skin.
atherosclerosis.
Somnolence and cold intolerance.
Thyroid scans are one means of evaluating the
thyroid gland for presence of a nodule. Scanning Pharmacologic Management - -Medical
also demonstrates the size, shape, function, and treatment for hypothyroidism is based on
position of the thyroid gland. Radioactive iodine replacement therapy. The HCP will monitor the
is administered PO or parenterally, and the client's goiter for now. The primary medication
uptake of the iodine by the thyroid gland is used to treat hypothyroidism is levothyroxine
measured. Clients with hypothyroidism will sodium. The HCP prescribes 1.7 mcg/kg body
demonstrate a decreased uptake of the weight/day. The client weights 150 lbs.
radioactive iodine. - -Further physical
examination reveals a slight obesity with a BMI of
27. While assessing the thyroid gland, the nurse What is the client'sdaily dose of medication?
finds a goiter. Goiter is the term for an enlarged (Enter numerical value only. If rounding is
thyroid gland. Depending on the cause of the necessary, round to the hundredth.) - -150
hypothyroidism, the client may have a goiter. A lbs = 68.18 kg
goiter can also be present with hyperthyroidism. 68.18 x 1.7 mcg = 115.9
Lab results indicate mild anemia and a TSH that 115.9 mcg/1000 = 0.115 mg
is 20 (normal is 0.5 to 5.0 microunits/mL).
Which approach by the nurse describes the
The client asks the nurse how she got this action of the levothyroxine? - -Increases
disease. Which explanation by the nurse is fat, protein, carbohydrate metabolism.
accurate? - -An autoimmune dysfunction -
causes thyroid dysfunction. The action of levothyroxine is the same as
endogenous thyroid hormone. The drug
The most common cause of hypothyroidism in increases the metabolic rate (increased oxygen
adults is autoimmune thyroiditis (Hashimoto's consumption, respiration and heart rate) and
disease) in which the immune system attacks the increases the rate of fat, protein, and
thyroid. More than 95% of clients either have carbohydrate metabolism. It promotes growth
primary or thyroidal hypothyroidism which refers and maturation.
to dysfunction of the thyroid itself.
Which information in the client's history would be
Which symptoms are the client with of concern to the nurse related to the use of
hypothyroidism most likely to exhibit? (Select all levothyroxine? - -The client takes a daily
that apply. One, some, or all options may be calcium supplement.
correct.) - -Somnolence and fatigue. -
2/5
Complete Solutions
Meet the Client - -The client works full time The client has signed the consent for the
as a high school math teacher. She is currently radioactive iodine uptake test. What are the most
working on a specialist degree, taking night important assessments for the nurse to obtain
classes at one of the local colleges. She noticed prior to the test? (Select all that apply. One,
that she is more sluggish than normal. She some, or all options may be correct.) - -Ask
doesn't have the energy for girls' nights out if the client has been taking any OTC
anymore, and for the past 4 months, she has not medications such as cough syrups? (Many OTC
attended her exercise classes. The client gained cough medications contain some iodine. There
10 pounds in the past 4 to 6 months. Her friends may not be enough to interfere with the test
say she acts depressed and encouraged her to results, but the information needs to be
see a healthcare provider (HCP) so she makes assessed.)
an appointment with the HCP.
Investigate the client's use of over the counter
(OTC) multivitamin and herbal products.(Many
The client's presenting vital signs: OTC multivitamins contain some iodine. There
Temperature: 96.0° F (36.0° C) may not be enough to interfere with the test
Pulse: 52 beats/minute results, but the information needs to be
Respirations: 18 breaths/minute assessed.)
Blood pressure: 140/80 mmHg
Given the initial history and vital signs, what Find out if the client has ever had a reaction to a
other questions should the nurse ask? (Select all bee sting.(Allergic reactions to bee stings and
that apply. One, some, or all options may be shell fish should be assessed.)
correct.) - -"Have you had any changes in
your bowel habits?"
Based on the client's history and presenting
"Do you still feel sleepy when you wake up in the symptoms, which additional diagnostic tests does
mornings despite getting a good night's sleep?" the nurse anticipate the HCP to order?(Select all
that apply. One, some, or all options may be
"Have you noticed any changes in your hair or correct.) - -CBC with differential. (The HCP
nails?" needs to rule out other possible causes of the
- client's symptoms which could include anemia or
Hypothyroidism can cause an infection.)
constipation.Hypothyroidism can cause sleep
disturbances.Hypothyroidism can cause hair loss Blood Chemistries.(Chemistries would be needed
and brittle nails. to evaluate the client's electrolyte and fluid
status.)
Diagnostic Tests - -The client is scheduled TSH and free T4. (These indicate the functioning
for a radioactive iodine uptake test. This test is or non-functioning of the thyroid gland.)
used to measure the rate of iodine uptake by the
thyroid gland. She is also scheduled for a thyroid
scan. Based on the health care provider's (HCP)
assessment and interpretation of the diagnostics,
the client is diagnosed with hypothyroidism.
Which other lab should be monitored after the
1/5
, NU272 HESI Case Study: Thyroid Disorders (week 4) with
Complete Solutions
diagnosis of hypothyroidism is confirmed? - (Hypothyroidism generally causes an individual to
-Triglycerides and cholesterol. have decreased initiative, somnolence, slowed
speech, fatigue and lethargy.)
Hypothyroidism can cause increased triglyceride
and cholesterol levels, leading to coronary Coarse dry skin.
atherosclerosis.
Somnolence and cold intolerance.
Thyroid scans are one means of evaluating the
thyroid gland for presence of a nodule. Scanning Pharmacologic Management - -Medical
also demonstrates the size, shape, function, and treatment for hypothyroidism is based on
position of the thyroid gland. Radioactive iodine replacement therapy. The HCP will monitor the
is administered PO or parenterally, and the client's goiter for now. The primary medication
uptake of the iodine by the thyroid gland is used to treat hypothyroidism is levothyroxine
measured. Clients with hypothyroidism will sodium. The HCP prescribes 1.7 mcg/kg body
demonstrate a decreased uptake of the weight/day. The client weights 150 lbs.
radioactive iodine. - -Further physical
examination reveals a slight obesity with a BMI of
27. While assessing the thyroid gland, the nurse What is the client'sdaily dose of medication?
finds a goiter. Goiter is the term for an enlarged (Enter numerical value only. If rounding is
thyroid gland. Depending on the cause of the necessary, round to the hundredth.) - -150
hypothyroidism, the client may have a goiter. A lbs = 68.18 kg
goiter can also be present with hyperthyroidism. 68.18 x 1.7 mcg = 115.9
Lab results indicate mild anemia and a TSH that 115.9 mcg/1000 = 0.115 mg
is 20 (normal is 0.5 to 5.0 microunits/mL).
Which approach by the nurse describes the
The client asks the nurse how she got this action of the levothyroxine? - -Increases
disease. Which explanation by the nurse is fat, protein, carbohydrate metabolism.
accurate? - -An autoimmune dysfunction -
causes thyroid dysfunction. The action of levothyroxine is the same as
endogenous thyroid hormone. The drug
The most common cause of hypothyroidism in increases the metabolic rate (increased oxygen
adults is autoimmune thyroiditis (Hashimoto's consumption, respiration and heart rate) and
disease) in which the immune system attacks the increases the rate of fat, protein, and
thyroid. More than 95% of clients either have carbohydrate metabolism. It promotes growth
primary or thyroidal hypothyroidism which refers and maturation.
to dysfunction of the thyroid itself.
Which information in the client's history would be
Which symptoms are the client with of concern to the nurse related to the use of
hypothyroidism most likely to exhibit? (Select all levothyroxine? - -The client takes a daily
that apply. One, some, or all options may be calcium supplement.
correct.) - -Somnolence and fatigue. -
2/5
