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) "I've been having problems with bladder control.": While bladder control issues can be associated with certain neurological conditions, they are not specific to myasthenia gravis. This statement may indicate a need for further assessment but does not directly suggest a need for occupational therapy.
B) "I have difficulty swallowing food.": Dysphagia is a common concern in myasthenia gravis, but this statement may warrant a referral to a speech-language pathologist rather than occupational therapy. Addressing swallowing difficulties typically falls within the scope of speech therapy.
C) "I would rather be in a wheelchair than use a walker to get around.": This statement reflects a personal preference for mobility aids. While it could indicate a need for assistance in mobility, it does not specifically point to a need for occupational therapy services.
D) "I have a hard time with brushing my hair.": This statement clearly indicates difficulty with activities of daily living (ADLs) due to muscle weakness associated with myasthenia gravis. A referral for occupational therapy would be appropriate to help the client develop strategies and adaptive techniques to manage daily tasks more effectively.
Correct Answer is B
Explanation
A) Chloride level: Chloride levels are generally not affected by gout. While electrolyte imbalances can occur in various conditions, they are not specifically associated with acute gout attacks.
B) Uric acid: An increase in uric acid levels is expected in clients with acute gout. Gout is caused by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. Monitoring uric acid levels is crucial for diagnosing and managing this condition.
C) Creatinine kinase: Creatinine kinase levels are typically elevated in conditions related to muscle damage or injury, rather than gout. While some muscle soreness may occur during a gout flare, it is not a primary indicator for this condition.
D) Intrinsic factor: Intrinsic factor is related to vitamin B12 absorption and is not relevant to gout. It is primarily associated with conditions like pernicious anemia rather than gout or uric acid metabolism.