Medical Surgical Thyroid #3

Question

The nurse analyzes the laboratory results for thyroid function and notices elevation of thyroid stimulating hormone (TSH) and decreased free thyroxine index and T4. The nurse will expect medication which will treat which thyroid condition?

Answers

  1. Hyperthyroidism
    • Rationale:

      This answer is not correct because hypothyroidism, not hyperthyroidism is what the laboratory results indicate. Elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism.

  2. Hypophysectomy
    • Rationale:

      This answer is not correct because hypophysectomy refers to the removal of the pituitary gland. TSH is produced in the pituitary so that levels would be decreased if a hypophysectomy had occurred. Elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism.

  3. Graves’ Disease
    • Rationale:

      This answer is not correct because Graves’ disease is a form of hyperthyroidism and the labs of hyperthyroidism would be opposite of the ones found in the lab result. Elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism.

  4. Hypothyroidism
    • Rationale:

      This answer is correct because laboratory results of elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism. The elevation of TSH shows a need for thyroid hormone so the pituitary is producing more TSH to stimulate the thyroid to produce more hormone that it is lacking, namely free thyroxine and T4. Unfortunately, the thyroid is not working properly due to hypothyroidism and cannot produce these hormones despite being stimulated to produce.

Overview

Elevation of thyroid stimulating hormone (TSH) and decreased free thyroxine index and T4 indicate hypothyroidism. The elevation of TSH shows a need for thyroid hormone so the pituitary is producing more TSH to stimulate the thyroid to produce more hormone that it is lacking, namely free thyroxine and T4.

Explanation

Learning Outcomes

Laboratory results of elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism. The elevation of TSH shows a need for thyroid hormone so the pituitary is producing more TSH to stimulate the thyroid to produce more hormone that it is lacking, namely free thyroxine and T4. Unfortunately, the thyroid is not working properly due to hypothyroidism and cannot produce these hormones despite being stimulated to produce.

Test Taking Tip

Anytime there are contrasting conditions being considered, be very careful in your answer selection to not get confused easily. The exam question is making sure you do not get those symptoms, labs, or treatments mixed up. It is important to know the differences well and focus and select carefully.

Video Rationale