A nurse is teaching a client who has Graves' disease about recognizing the manifestations of thyroid storm. Which of the following findings should the nurse include in the teaching?
Decreased heart rate
Increased temperature
Lethargy
Hypotension
The Correct Answer is B
A) Decreased heart rate: In thyroid storm, the heart rate typically increases due to elevated levels of thyroid hormones. A decreased heart rate would not be characteristic of this condition.
B) Increased temperature: One of the hallmark signs of thyroid storm is hyperthermia or increased body temperature, often exceeding 101°F (38.3°C). This is due to the heightened metabolic state caused by excess thyroid hormones.
C) Lethargy: While lethargy can occur in other thyroid-related issues, thyroid storm is more commonly associated with hyperactivity and agitation rather than lethargy. Clients may present with restlessness and confusion.
D) Hypotension: In thyroid storm, clients often experience hypertension rather than hypotension. The increased metabolic demands can lead to elevated blood pressure due to increased cardiac output and peripheral vasodilation.
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Correct Answer is B
Explanation
A) Epinephrine: Epinephrine is primarily used in emergencies for conditions such as anaphylaxis or cardiac arrest. It would not be indicated for managing thirst or urinary output
in this context.
B) Desmopressin: This medication is a synthetic vasopressin analog used to treat diabetes insipidus, which can result from brain injuries affecting the hypothalamus or pituitary gland. Given the client's significant urinary output of 4,000 mL, which suggests possible diabetes insipidus, desmopressin is the most appropriate medication to address the excessive urination and thirst.
C) Nitroprusside: Nitroprusside is a potent vasodilator used to manage acute hypertension. It is not relevant to the symptoms described and would not help in managing thirst or urinary output issues.
D) Furosemide: Furosemide is a diuretic that would increase urinary output rather than decrease it. Since the client is already experiencing high urinary output, furosemide would not be appropriate.
Correct Answer is B
Explanation
A)"Iwilltrytolimitfoodsthatcontainsalt.":Limitingsaltintakeisimportantformanagingheartfailurebutdoesn'tspecificallyaddresstheadverseeffectsoffurosemide.Thisdiureticcancauseelectrolyteimbalances,butsaltrestrictionismorerelatedtooverallheartfailuremanagement.
B)"I'mgoingtoincludemorecantaloupeinmydiet.":Furosemidecancausepotassiumdepletion,andcantaloupeishighinpotassium.Increasingpotassium-richfoodsinthediethelpscounteractthisadverseeffect,indicatingtheclientunderstandstheneedtomaintainelectrolytebalance.
C)"IwillcheckmypulsebeforeItakethemedication.":Whilemonitoringheartratecanbeusefulinmanagingheartconditions,itisnotspecifictotheprimaryadverseeffectsoffurosemide.Thekeyconcernwiththismedicationisitsimpactonelectrolytesandfluidbalance.
D)"I'llcheckmybloodpressuresoitdoesn'tgettoohigh.":Furosemidetypicallylowersbloodpressure,sotheconcernwouldbehypotension(lowbloodpressure)ratherthanhypertension(highbloodpressure).Thisstatementdoesn’treflectanunderstandingoffurosemide’sprimaryadverseeffects.