A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated. The client says to the nurse, "I don't understand why my TSH is high. I thought I had low thyroid levels."

Question

The most appropriate response by the nurse is:
1. "You probably misunderstood your health care provider."
2. "TSH is a hormone released by the pituitary that signals your thyroid to make hormones. When the thyroid can't respond, the pituitary keeps trying to send its signal, and the TSH keeps going up."
3. "TSH is not thyroid hormone. When thyroid values are low, other lab tests are performed to see how you tolerate the low levels."
4. "TSH is an incomplete thyroid hormone. Because it cannot bind to tissues, it builds up in the bloodstream."

Answer 1

Correct Answer: 2
Rationale 1: This is not an appropriate response. The nurse needs to respond to the client's statement.
Rationale 2: TSH values increase in most cases of hypothyroidism because the thyroid gland is nonresponsive, so the normal negative feedback to the hypothalamus does not occur.
Rationale 3: The information in this statement might be correct; however, it does not address the client's statement about an elevated TSH level.
Rationale 4: TSH is not an incomplete thyroid hormone.
Global Rationale: TSH values increase in most cases of hypothyroidism because the thyroid gland is nonresponsive, so the normal negative feedback to the hypothalamus does not occur. TSH is not an incomplete thyroid hormone. The nurse should directly address the patient's concerns.