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) A client who has diabetes mellitus and is presenting with acute ketoacidosis: While this client requires careful monitoring and may need a private room if they are at risk for complications, they generally do not require isolation from other clients.
B) A client who has a compound fracture of the right femur: This client does not require a private room. Although they may need specific positioning and care, there are typically no infectious or isolation concerns.
C) A client who reports having fever, right sweats, and cough for 2 days: This client requires a private room due to the possibility of an infectious condition, such as pneumonia or tuberculosis. Symptoms like fever and cough, along with sweating, raise concerns about contagious diseases, making isolation necessary to protect other clients.
D) An older adult client who was admitted with aspiration pneumonia: While this client may need close monitoring, they do not automatically require a private room unless there are additional infection control concerns or if they are particularly contagious.
Correct Answer is D
Explanation
A) Check settings of the CPM machine every 12 hr: This is not frequent enough. The nurse should check the settings of the CPM machine more regularly, typically before each use or every few hours, to ensure the settings are appropriate for the client's therapy.
B) Increase the range of motion rapidly when the CPM machine is used intermittently: This approach is not safe. The range of motion should be increased gradually based on the healthcare provider's orders and the client's tolerance to avoid injury or discomfort.
C) Store the CPM machine on the floor when not in use: Storing the CPM machine on the floor can pose safety hazards, such as tripping or damage to the machine. It should be stored in a safe, designated area when not in use.
D) Turn the CPM machine off while the client is eating: This is an appropriate action. It allows the client to eat comfortably and without obstruction, ensuring they can focus on eating without the machine interfering. Once the client has finished eating, the CPM machine can be turned back on to continue therapy.