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 D
Explanation
A) Temperature of 37.9° C (100.2° F): A slight elevation in temperature can be common after surgery and may not indicate a serious issue. It should be monitored, but it is not immediately concerning.
B) Urine output 150 mL over 4 hr: While urine output is an important indicator of kidney function and overall perfusion, this output may still be acceptable depending on the client's overall fluid status and other factors. It does not necessarily require immediate reporting unless there are other concerning symptoms.
C) Bruising around the incisional site: Some bruising can be expected after surgery, particularly with arterial procedures. It should be monitored, but unless there are signs of excessive bleeding or hematoma formation, it is not typically an urgent concern.
D) Pallor in the affected extremity: This finding is critical and should be reported immediately. Pallor could indicate compromised blood flow to the extremity, which could be a sign of complications such as graft occlusion or inadequate perfusion. Prompt intervention may be necessary to prevent serious complications or tissue loss.
Correct Answer is D
Explanation
A)"Ishouldusenaturalskincondomsduringsexualintercourse.":Naturalskincondomsdonotprotectagainstviralinfectionslikeherpes.Latexorpolyurethanecondomsshouldbeusedtohelpreducetheriskoftransmittinggenitalherpes.
B)"Ishouldapplyantibioticointmenttothelesions.":Antibioticointmentsarenoteffectiveagainstviralinfectionslikeherpes.Antiviralmedicationsarenecessarytotreatandmanageherpeslesions.
C)"Ishouldexpectmylesionstoresolvein6weeks.":Lesionsfromgenitalherpestypicallyresolvewithinafewweeks,notsix.Aprolongeddurationmightindicatecomplicationsortheneedforadditionalmedicalevaluation.
D)"Ishouldexpecttotakemymedicationfor3weeks.":Antiviralmedicationsareoftenprescribedforaspecificduration,suchasthreeweeks,tohelpmanagetheoutbreakandreducesymptoms.Thisindicatestheclientunderstandsthetreatmentregimen.