A nurse is collecting data from the medical record of an older adult client and sees that the client is taking Amiodarone. The client, has reported feeling frequently tired and unable to tolerate the heat. Which of the following conditions should the nurse suspect?
Elevated thyroid hormone levels
Low blood glucose levels
Elevated blood glucose levels
Low thyroid hormone levels
The Correct Answer is D
A. Elevated thyroid hormone levels. While amiodarone can cause thyroid dysfunction, elevated thyroid levels (hyperthyroidism) would typically present with symptoms like increased energy or restlessness.
B. Low blood glucose levels. Low blood glucose is not related to amiodarone. Symptoms of hypoglycemia include sweating, hunger, and confusion, not heat intolerance or fatigue.
C. Elevated blood glucose levels. Hyperglycemia is not a known side effect of amiodarone.
D. Low thyroid hormone levels. Amiodarone can induce hypothyroidism, which may cause fatigue and heat intolerance. Regular thyroid monitoring is recommended with long-term amiodarone use.
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Correct Answer is A
Explanation
A. Shortness of breath while lying down. Shortness of breath when lying down, or orthopnea, is common in left-sided heart failure due to fluid backing up into the lungs, causing pulmonary congestion.
B. Jugular venous distention. Jugular venous distention is more commonly associated with right-sided heart failure due to systemic venous congestion.
C. Right upper quadrant pain. Right upper quadrant pain is associated with liver congestion due to right-sided heart failure, not left-sided heart failure.
D. Pitting edema of the lower legs. Pitting edema is a symptom of right-sided heart failure, as fluid backs up into the peripheral circulation.
Correct Answer is B
Explanation
A. Obtain a blood sample. Although obtaining a blood sample is essential for cardiac enzyme levels, it is not the highest priority. Addressing oxygenation takes precedence to relieve hypoxia.
B. Initiate oxygen therapy. Oxygen is the first priority to improve oxygenation in a client showing signs of hypoxia (cyanosis, dyspnea), which can prevent further ischemic damage to the heart.
C. Attach the leads for a 12-lead ECG. While obtaining an ECG is essential for diagnosing myocardial ischemia, ensuring oxygenation is more critical in this moment.
D. Insert the IV catheter. An IV line is necessary to administer fluids and medications, but oxygenation should be prioritized first to stabilize the client.