An older adult client with hyperthyroidism is not a candidate for surgery. Which treatment could be used to quickly reduce the clinical manifestations that the client is experiencing as a result of the disorder?
A) Nothing, because there is little effect on the quality of life in older adults.
B) A partial thyroidectomy
C) The ingestion of radioactive sodium iodine, I131
D) A combination treatment with levothyroid (Synthroid) and amiodarone (Cordarone)
Answer: C
Hyperthyroidism in older clients is most often caused by Graves disease or toxic nodular goiter, which is diagnosed by subnormal or undetectable levels of TSH (thyroid-stimulating hormone). The treatment of choice is the ingestion of radioactive iodine, which is picked up by the thyroid tissue and then destroys the tissue. This treatment avoids surgery, anesthesia, and hospitalization. Surgical removal is reserved for clients with symptoms too severe for treatment with radioactive iodine or nodules suspicious for malignancy. Treatment with levothyroid (Synthroid) would worsen symptoms, and amiodarone (Cordarone) is an antiarrhythmic drug that has induced hyperthyroidism in some clients. Older clients with hyperthyroidism seldom present with the classic symptoms seen in younger clients, but older clients may develop cardiac dysrhythmias, weight loss, fatigue, and apathy, and do require treatment. A partial thyroidectomy is a surgical procedure, for which the client is not a candidate.
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