A nurse is assessing a client who has hypothyroidism. The nurse should expect which of the following findings?
Exophthalmos
Weight gain
Diaphoresis
Palpitations
The Correct Answer is B
Rationale:
A. Exophthalmos is typically associated with hyperthyroidism, particularly in Graves' disease, and is not a characteristic finding in hypothyroidism.
B. Weight gain is a common symptom of hypothyroidism due to the slowed metabolism caused by reduced thyroid hormone levels. Clients often report unexplained weight gain despite maintaining a normal diet and activity level.
C. Diaphoresis, or excessive sweating, is more commonly associated with hyperthyroidism, where increased metabolism leads to heat intolerance and sweating.
D. Palpitations are also more commonly associated with hyperthyroidism, where an increased heart rate and heightened sensitivity to adrenaline are common. In hypothyroidism, bradycardia or a slowed heart rate may be observed instead.
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Correct Answer is D
Explanation
Rationale:
A. Hypertension can be a symptom of many conditions and is not specific to HHS.
B. Fruity breath is typically associated with diabetic ketoacidosis (DKA) due to the presence of acetone, not HHS.
C. Ketosis is a key feature of DKA, not HHS. In HHS, ketosis is usually absent or minimal.
D. A glucose level of 650 mg/dL is indicative of HHS, which is characterized by extremely high blood glucose levels without significant ketosis. HHS often occurs in type 2 diabetes and is marked by severe hyperglycemia, dehydration, and altered mental status.
Correct Answer is C
Explanation
Rationale:
A. Assisting the client to the bathroom might be helpful, but it is not the first action the nurse should take since the client hasn't voided for an extended period.
B. Increasing fluids may be beneficial but does not address the immediate concern of whether there is a problem with urinary retention.
C. Performing a bladder scan is the first action to determine if there is urine retention in the bladder. This information is crucial before deciding on further interventions, such as catheterization.
D. Inserting a straight catheter may be necessary if significant urinary retention is confirmed, but it should not be the first action without knowing the bladder's status.