A client is admitted to the hospital for treatment of a simple goiter, and levothyroxine sodium is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client?
Bradycardia and constipation.
Muscle cramping and dry, flushed skin.
Palpitations and shortness of breath.
Lethargy and lack of appetite.
The Correct Answer is C
A. Bradycardia and constipation are symptoms associated with hypothyroidism, not hyperthyroidism, indicating that the dosage may be too low rather than too high.
B. Muscle cramping and dry, flushed skin are not typical indicators of levothyroxine overdose and may reflect other underlying issues.
C. Palpitations and shortness of breath are symptoms indicative of hyperthyroidism, suggesting that the levothyroxine dosage may be too high, leading to an increased metabolic rate and cardiovascular stress.
D. Lethargy and lack of appetite are more consistent with under-treatment or hypothyroidism rather than an overdose of levothyroxine, which typically stimulates metabolic activity.
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Correct Answer is D
Explanation
A. Joint pain is a common symptom of systemic lupus erythematosus (SLE) and, while it may indicate an exacerbation of the disease, it is not the most critical finding to report.
B. A low-grade fever can signify an infection or increased disease activity but is generally not as urgent as changes in renal function or systemic involvement.
C. Muscle atrophy is a concern over time but does not pose an immediate threat to the client’s health compared to acute changes in kidney function.
D. Hematuria is significant in SLE as it can indicate renal involvement, such as lupus nephritis, which can lead to severe complications. This finding requires prompt reporting and assessment to prevent further renal damage and manage potential complications effectively.
Correct Answer is B
Explanation
A. A soft diet may not provide sufficient fiber, which is essential for managing diverticulosis and preventing complications such as diverticulitis.
B. A high fiber diet helps to bulk up stool and promotes regular bowel movements, reducing the risk of complications associated with diverticulosis. Increased fluid intake is also essential to help fiber work effectively in the digestive system.
C. While sitting up after meals can aid digestion, it is not a primary dietary instruction for managing diverticulosis.
D. A bland diet may not be necessary; the focus should be on increasing fiber intake rather than avoiding specific flavors or spices unless they cause discomfort.