A nurse is receiving a patient from the emergency room (ER) with an admitting diagnosis of hypothyroid disorder.
Admitting diagnosis
acute hypothyroid disorder
Physician order
Synthroid 0.1 mg po daily
The receiving medical- surgical nurse would expect the patient to exhibit which signs and symptoms? Select all that apply
cold intolerance
depression dry skin
weakness and fatigue
constipation
mental alertness
Correct Answer : A,B,C,D
A. Cold intolerance: Patients with hypothyroidism often have difficulty regulating body temperature, leading to a heightened sensitivity to cold.
B. Depression: Hypothyroidism can affect mood and cognitive function, often leading to symptoms of depression.
C. Weakness and fatigue: Low thyroid hormone levels can cause significant fatigue and muscle weakness due to a slower metabolism.
D. Constipation: A slowed metabolism can also affect gastrointestinal motility, resulting in constipation.
E. Mental alertness: This is typically not expected in hypothyroid patients. In fact, they may experience cognitive impairments, memory issues, or slowed thinking rather than mental alertness.
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Correct Answer is B
Explanation
A. Observing for facial symmetry assesses cranial nerves VII (facial nerve) rather than cranial nerve III.
B. Checking the pupillary response to light assesses cranial nerve III (oculomotor nerve), which controls pupil constriction and extraocular eye movements.
C. Testing visual acuity assesses cranial nerve II (optic nerve), not cranial nerve III.
D. Eliciting the gag reflex assesses cranial nerves IX (glossopharyngeal) and X (vagus), not cranial nerve III.
Correct Answer is C
Explanation
A. Metabolic alkalosis is characterized by a high pH and elevated bicarbonate levels, which is not present in these results.
B. Respiratory alkalosis would present with an increased pH and decreased PaCO2, which does not apply here.
C. The low pH (7.12) indicates acidemia, and the elevated PaCO2 (90 mm Hg) suggests hypoventilation and respiratory acidosis due to CO2 retention. The bicarbonate level is within normal limits, further supporting respiratory acidosis.
D. Metabolic acidosis would be indicated by a low pH and low bicarbonate levels; however, the bicarbonate is normal in this case, ruling out metabolic acidosis.