Medical Surgical Thyroid #14

Question

The nurse is assessing a client who voices concerns about having thyroid disease. Which question by the nurse is most appropriate?

Answers

  1. “Have you experienced muscle spasms or cramping?”
    • Rationale:

      This answer is not correct because asking if a client has had muscle spasms or cramping could help identify electrolyte imbalance or gastrointestinal concerns, but does not help determine thyroid dysfunction. Symptoms of hyperthyroidism include tachycardia, heat intolerance, amenorrhea, weight loss, anxiety, tremor, hypertension, irregular heart rate, palpitations, sweating, fatigue, diarrhea, protruded eyes (exophthalmos), and insomnia. Hypothyroidism symptoms include bradycardia, sexual dysfunction, irregular uterine bleeding, cold sensitivity, weight gain, lethargy, dry skin, constipation, hair loss, and sluggishness. Questions regarding these symptoms would help direct more tests to determine thyroid dysfunction.

  2. “Have you experienced tingling, numbness, or changes in sensation?”
    • Rationale:

      This answer is not correct because asking a client about the presence of tingling, numbness, or changes in sensation is assessing electrolyte imbalance and neurologic changes, not thyroid dysfunction. Symptoms of hyperthyroidism include tachycardia, heat intolerance, amenorrhea, weight loss, anxiety, tremor, hypertension, irregular heart rate, palpitations, sweating, fatigue, diarrhea, protruded eyes (exophthalmos), and insomnia. Hypothyroidism symptoms include bradycardia, sexual dysfunction, irregular uterine bleeding, cold sensitivity, weight gain, lethargy, dry skin, constipation, hair loss, and sluggishness. Questions regarding these symptoms would help direct more tests to determine thyroid dysfunction.

  3. “Have you experienced weight gain or loss during the past 3 months?”
    • Rationale:

      This answer is correct. Thyroid disorders have symptoms of weight loss (hyperthyroidism) or weight gain (hypothyroidism). Asking a client about recent weight changes will help the nurse determine if there is a thyroid disorder concern. Symptoms of hyperthyroidism include tachycardia, heat intolerance, amenorrhea, weight loss, anxiety, tremor, hypertension, irregular heart rate, palpitations, sweating, fatigue, diarrhea, protruded eyes (exophthalmos), and insomnia. Hypothyroidism symptoms include bradycardia, sexual dysfunction, irregular uterine bleeding, cold sensitivity, weight gain, lethargy, dry skin, constipation, hair loss, and sluggishness. Questions regarding these symptoms would help direct more tests to determine thyroid dysfunction.

  4. “Have you experienced episodes of shakiness, sweating, or extreme hunger?”
    • Rationale:

      This answer is not correct because questions about shakiness, sweating, or extreme hunger is assessing hypoglycemia and diabetes symptoms, not thyroid dysfunction. Symptoms of hyperthyroidism include tachycardia, heat intolerance, amenorrhea, weight loss, anxiety, tremor, hypertension, irregular heart rate, palpitations, sweating, fatigue, diarrhea, protruded eyes (exophthalmos), and insomnia. Hypothyroidism symptoms include bradycardia, sexual dysfunction, irregular uterine bleeding, cold sensitivity, weight gain, lethargy, dry skin, constipation, hair loss, and sluggishness. Questions regarding these symptoms would help direct more tests to determine thyroid dysfunction.

Overview

Thyroid disorders have symptoms of weight loss (hyperthyroidism) or weight gain (hypothyroidism). Asking a client about recent weight changes will help the nurse determine if there is a thyroid disorder concern.

Explanation

Learning Outcomes

Graves’disease is an autoimmune disease where the body attacks the thyroid and makes it produce excess thyroid hormone. Symptoms of Graves’ disease are the same as hyperthyroidism, which reflect an increased metabolism related to excess thyroid hormones. Symptoms include tachycardia, heat intolerance, amenorrhea, weight loss, anxiety, tremor, hypertension, irregular heart rate, palpitations, sweating, fatigue, diarrhea, protruded eyes (exophthalmos), and insomnia. Hypothyroidism symptoms are mostly opposite of hyperthyroidism because this condition is associated with decreased thyroid hormones and decreased metabolism. These symptoms include bradycardia, sexual dysfunction, irregular uterine bleeding, cold sensitivity, weight gain, lethargy, dry skin, constipation, hair loss, and sluggishness.

Test Taking Tip

Remember weight gain in hypothyroidism is related to slowed metabolism and likely closely connected to the fatigue, depression, and sluggishness. The client should be taught to watch caloric intake and increase activity through exercise.

Video Rationale