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. Adjusting the rate of the bladder irrigation might be necessary, but it is not the first action to take when there is no drainage.
B. Ambulating the client can help promote bladder function, but it is not the immediate priority when assessing catheter function.
C. Notifying the provider is important if the issue cannot be resolved, but the nurse should first attempt to resolve common, simple issues like a kinked tube.
D. Checking the tubing for kinks is the most immediate and logical first action to take. Kinks in the tubing can obstruct urine flow, and correcting this can often resolve the issue without further intervention.
Correct Answer is ["B","E","F"]
Explanation
Rationale:
A. The vital signs are stable and within normal limits. The slight drop in blood pressure post-dialysis is expected and not immediately concerning.
B. The client's weight decreased from 90 kg (198 lb) to 86.4 kg (190 lb) after dialysis. While weight loss is expected due to fluid removal during dialysis, this significant decrease (3.6 kg or approximately 8 lb) may need closer monitoring to ensure the client is not becoming dehydrated or losing more fluid than is safe.
C. The blood glucose levels are within an acceptable range for a client with type 2 diabetes mellitus. The slight decrease from 134 mg/dL to 75 mg/dL is not unusual given the time between measurements and the client's food intake.
D. The presence of a bruit and thrill at the AV fistula site indicates that it is functioning correctly, which is an expected finding.
E. The presence of crackles in the left lower lobe and an unproductive cough on the morning of Day 2 is concerning. These symptoms could indicate fluid overload or early signs of pulmonary edema, which require further evaluation and possible intervention.
F. The AV fistula site is noted to be ecchymotic and warm, with a bruit and thrill still present. While a bruit and thrill are expected findings, the ecchymosis and warmth could indicate a developing infection or trauma at the site, which necessitates further follow-up to prevent complications.