A newborn is admitted to the pediatric unit to rule out congenital hypothyroidism. Which of the following findings would the nurse expect if this diagnosis is confirmed?
Bradycardia, constipation, and hypotonia
Elevated serum T3 and T4
Tachycardia, diarrhea, and tremors
Decreased thyroid stimulating hormone (TSH)
The Correct Answer is A
Rationale:
A. Bradycardia, constipation, and hypotonia are common symptoms associated with congenital hypothyroidism due to the reduced metabolism that results from decreased thyroid hormone levels.
B. Elevated serum T3 and T4 would not be expected in congenital hypothyroidism; these levels are typically low.
C. Tachycardia, diarrhea, and tremors are more indicative of hyperthyroidism, not hypothyroidism.
D. In congenital hypothyroidism, the thyroid-stimulating hormone (TSH) is typically elevated as the body attempts to stimulate the thyroid gland to produce more hormones.
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Correct Answer is D
Explanation
Rationale:
A. While monitoring blood pressure is important, a blood pressure of 98/62 mm Hg may not immediately warrant notification unless there are signs of hypotension or other symptoms. The focus should be on careful management of fluid and electrolytes.
B. In cases of acute renal failure, potassium levels can become elevated due to impaired renal function. Therefore, IV fluids should typically be low in potassium to prevent hyperkalemia.
C. In acute renal failure, a diet high in protein and sodium is not recommended. Instead, dietary restrictions are usually advised to manage waste products and fluid balance.
D. Administering IV fluids slowly helps to prevent fluid overload, which is crucial in managing renal failure and maintaining hemodynamic stability.
Correct Answer is B
Explanation
Rationale:
A. Offering a pacifier is contraindicated after cleft lip and palate repair as it can disrupt the surgical site and interfere with healing.
B. Maintaining elbow restraints prevents the infant from touching or putting objects in their mouth, which could disrupt the surgical site and compromise healing.
C. The Trendelenburg position is not recommended as it can increase pressure on the surgical site and compromise breathing.
A
D. An ice collar may be used for pain relief in older children or adults but is not typically used in infants, and it may not be feasible in this population.