Hyperthyroidism

Exophthalmos (abnormal protrusion of the eye) is characteristic of patients with hyperthyroidism due to Graves’ disease. Periorbital edema, bradycardia, and hoarse voice are all characteristics of patients with hypothyroidism. Focus: Prioritization

Doses of over 30 mg/day may increase the risk of agranulocytosis. Lugol’s solution does not act to prevent tetany. Calcium is used to treat tetany. The client may receive iodine solution (Lugol’s solution) for 10 to 14 days before surgery to decrease vascularity of the thyroid and thus prevent excess bleeding. Lugol’s solution does not potentiate any other preoperative medication.

Though fluid volume status, neurological status and pain are all important assessment, the immediate priority for postoperative is the airway management. Respiratory distress may result from hemorrhage, edema, laryngeal damage or tetany.

T3 and T4, also known as thyroid hormones, play a crucial role in regulating energy production in the body. These hormones are responsible for controlling the metabolism of cells, which affects how the body uses energy. They stimulate the production of ATP, the energy currency of cells, and regulate the breakdown of fats, proteins, and carbohydrates to provide energy. Therefore, the correct answer is "Regulation of energy production."

In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body requirements the most important nursing diagnosis.

After subtotal thyroidectomy, swelling of the surgical site ( the tracheal area) may obstruct the airway. Therefore tracheostomy set should be at the bedside in case of respiratory emergency.

In a patient with hyperthyroidism and risk for thyrotoxic crisis or thyroid storm, monitoring vital signs is the most important nursing assessment. Vital signs such as heart rate, blood pressure, respiratory rate, and temperature can provide crucial information about the patient's cardiovascular and metabolic status. Hyperthyroidism can cause an increase in heart rate and blood pressure, and monitoring these vital signs can help detect any abnormalities or signs of worsening thyrotoxic crisis. Assessing vital signs regularly allows for early identification and prompt intervention in case of any deterioration in the patient's condition.

In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body requirements the most important nursing diagnosis.

Lugol’s solution provides iodine, which aids in decreasing the vascularity of the thyroid gland, which limits the risk of hemorrhage when surgery is performed.

Monitoring and recording vital signs are within the education scope of nursing assistants. An experienced nursing assistant should have been taught how to monitor the apical pulse. However, the nurse should observe the nursing assistant to be sure that she has mastered this skill. Instructing and teaching patients, as well as performing venipuncture for laboratory samples, are more suited to the educational scope of licensed nurses. In some facilities, an experienced nursing assistant may perform venipuncture, but only after special training. Focus: Delegation/supervision

The cardiac problems associated with hyperthyroidism include tachycardia, increased systolic blood pressure, and decreased diastolic blood pressure. Patients with hyperthyroidism also may have increased body temperature related to increased metabolic rate. Focus: Delegation/supervision

In addition to the above-mentioned complications of uncontrolled hyperthyroidism in pregnancy, expectant mothers may suffer congestive heart failure and thyroid storm, which is life-threatening thyrotoxicosis with symptoms that include agitation, confusion, tachycardia, shaking, sweating, diarrhea, fever, and restlessness.

Increased thirst and increased urination are signs of lithium toxicity.

In the TSH test, failure of the TSH level to rise after 30 minutes confirms hyperthyroidism. A decreased TSH level indicates a pituitary deficiency of this hormone. Below-normal levels of T3 and T4, as detected by radioimmunoassay, signal hypothyroidism. A below-normal T4 level also occurs in malnutrition and liver disease and may result from administration of phenytoin and certain other drugs.