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) Alert the emergency response team: While alerting the team is important, it should not be the first action taken. Immediate care to protect the client’s integrity is the priority before involving additional personnel.
B) Cover the area with sterile normal saline-soaked gauze: This is the most immediate and critical action. Covering the exposed bowel with sterile saline-soaked gauze helps to prevent infection and keeps the tissue moist, which is essential until surgical intervention can be performed.
C) Place the head of the client's bed at a 15° angle: While positioning the client can help with comfort and possibly reduce further protrusion, it is not the priority action in this emergency situation. The exposed bowel requires immediate protection.
D) Prepare the client for surgery: Preparing for surgery is a necessary step, but it should follow the immediate care for the exposed intestine. Ensuring that the bowel is covered and protected takes precedence.
Correct Answer is ["A","B","C"]
Explanation
A) Chronic infections of the middle ear: Chronic middle ear infections can lead to damage of the structures within the ear, resulting in conductive hearing loss. This is a significant risk factor for hearing loss, particularly in children and young adults.
B) Use of a loop diuretic: Loop diuretics, such as furosemide, can be ototoxic, especially at high doses or when used in conjunction with other ototoxic medications. This can result in hearing loss, making this a relevant risk factor to discuss.
C) Perforation of the eardrum: A perforated eardrum can lead to conductive hearing loss and increase the risk of infections, which may further compromise hearing. It is essential to include this in the discussion of risk factors for hearing loss.
D) Born with a high birth weight: High birth weight alone is not a recognized risk factor for hearing loss. While certain conditions associated with high birth weight may impact hearing, it is not a direct factor.
E) Frequent exposure to low-volume noise: Low-volume noise exposure is typically not a risk factor for hearing loss. It is the exposure to loud noise over time that poses a greater risk. Therefore, this factor should not be included in the teaching.