*NURSING > EXAM REVIEW > NR 511 Week 6 latest (All)
Quiz 6 Question 1 1 / 1 pts A client with hyperthyroidism presents with a complaint of a feeling in her eyes. Over the past week, her visual acuity has diminished, and her ability to see colors ... has changed. She also has a feeling of pressure behind her eyes. The next step for the nurse practitioner is to: Order a total thyroxine (T4). Refer the client for immediate evaluation by an ophthalmologist. Order a thyroid ultrasound. Prescribe a beta-adrenergic blocker. The practitioner should refer the client for an immediate evaluation by an ophthalmologist. Clinically recognized Graves ophthalmopathy occurs in about 50% of cases of Graves disease. A client with Graves orbitopathy with these complaints is at risk of blindness if there is compression of the optic nerve. Additional symptoms include photophobia and diplopia. Autoantibodies present in Graves disease can cause increased muscle thickness in the eye, leading to edema and compression of the optic nerve. Fundal exam may reveal disk swelling. This is an emergency situation that may require hospitalization and treatment with prednisone to diminish the inflammation. Artificial tears are also helpful. In 75% of clients, the onset of Graves orbitopathy occurs within a year before or after the diagnosis of thyrotoxicosis but can sometimes precede or follow thyrotoxicosis by several years. Question 2 1 / 1 pts A low thyroid-stimulating hormone (TSH) can lead to: Brittle hair. Osteoporosis. Weight gain. Bradycardia. Hyperthyroidism presents with a suppressed TSH and elevated free thyroxine (FT4). Manifestations include weight loss, tachycardia, diarrhea, anxiety, and warm, silky skin. The increased metabolic state of hyperthyroidism can cause cardiac dysrhythmias and osteoporosis. The clinical manifestations can also occur when there is excessive thyroid replacement. [Show More]
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