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.
Free Nursing Test Bank
- Free Pharmacology Quiz 1
- Free Medical-Surgical Quiz 2
- Free Fundamentals Quiz 3
- Free Maternal-Newborn Quiz 4
- Free Anatomy and Physiology Quiz 5
- Free Obstetrics and Pediatrics Quiz 6
- Free Fluid and Electrolytes Quiz 7
- Free Community Health Quiz 8
- Free Promoting Health across the Lifespan Quiz 9
- Free Multidimensional Care Quiz 10
View Related questions
Correct Answer is A
Explanation
A) Check the pulse distal to the graft: This action is crucial for assessing the patency of the arteriovenous graft. Monitoring the pulse distal to the graft ensures adequate blood flow and helps detect any complications such as thrombosis or compromised circulation.
B) Keep the left forearm below the level of the heart: Keeping the forearm below heart level is not necessary and could potentially compromise circulation. The limb should be elevated as tolerated to reduce swelling and promote healing.
C) Collect blood specimens from the graft: Collecting blood specimens from the graft site is not appropriate, as it can increase the risk of infection and damage to the graft. Blood samples should typically be drawn from another site.
D) Splint the left forearm to prevent damage to the graft: While protecting the graft site is important, splinting is generally not required unless specifically ordered for a particular reason. The focus should be on gentle use and monitoring rather than immobilization.
Correct Answer is A
Explanation
A) Photophobia: This is a common symptom associated with meningitis. Inflammation of the meninges can lead to sensitivity to light, making photophobia a significant finding during the assessment of a client with meningitis. This symptom can cause discomfort and may lead clients to avoid bright environments.
B) Intermittent headache: While headaches are a common symptom of meningitis, they are typically severe and persistent rather than intermittent. Clients often report a continuous, severe headache that is different from their usual headaches, which is more indicative of meningitis.
C) Petechiae on the chest: Although petechiae can occur in certain types of meningitis, particularly meningococcal meningitis, it is not a universal finding. The presence of petechiae would suggest a more severe systemic involvement, but it is not expected in every case of meningitis.
D) Bradycardia: This is not a typical finding in meningitis. In fact, tachycardia (increased heart rate) is more commonly seen due to fever and infection. Bradycardia might indicate a different underlying issue and is not expected in the context of meningitis.