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 C
Explanation
A) Generalized abdominal pain: While abdominal pain can occur with peritonitis, it is not always the earliest indication. Pain may develop after other symptoms become apparent, making it less specific as an initial sign.
B) Fever: Fever is a common symptom of infection, including peritonitis. However, it can also occur in various other conditions and may not be the first noticeable symptom, especially if the infection is localized.
C) Cloudy effluent: Cloudy or turbid dialysate effluent is often the earliest and most specific indication of peritonitis in patients undergoing peritoneal dialysis. This change in the appearance of the effluent suggests an infection, and the presence of cloudy fluid should prompt further evaluation for peritonitis.
D) Increased heart rate: An increased heart rate can be a response to various conditions, including infection, but it is not specific to peritonitis and may not be the earliest sign.
Correct Answer is C
Explanation
A) Lidocaine: Lidocaine is primarily used for the management of ventricular arrhythmias, particularly in cases of ventricular tachycardia or ventricular fibrillation. It is not indicated for treating sinus bradycardia and ST segment elevation.
B) Digoxin: Digoxin is used to treat atrial fibrillation and heart failure but is not appropriate for acute management of sinus bradycardia. In fact, digoxin can potentially worsen bradycardia by increasing vagal tone.
C) Atropine: Atropine is the drug of choice for acute management of symptomatic bradycardia. It works by blocking the effects of the vagus nerve on the heart, which can increase heart rate. Given the client's symptoms of shortness of breath and dizziness, atropine is appropriate to help stabilize their condition.
D) Sotalol: Sotalol is an antiarrhythmic medication used primarily for atrial fibrillation and ventricular arrhythmias. It is not indicated for the treatment of bradycardia and may even exacerbate the condition.