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 A
Explanation
A) "Floss your teeth gently following each meal.": This instruction is appropriate for a client with mucositis. Gentle flossing can help maintain oral hygiene and reduce the risk of infection without causing additional trauma to the already sensitive mucous membranes. It's important to emphasize a gentle approach to minimize discomfort.
B) "Rinse your mouth with hydrogen peroxide.": Rinsing with hydrogen peroxide is not recommended for clients with mucositis, as it can be irritating to the mucous membranes and exacerbate discomfort. Alternatives such as saline or baking soda rinses are typically suggested instead.
C) "Wear your dentures only during meals.": While this may seem practical, clients with mucositis are often advised to avoid dentures altogether if possible, as they can irritate the mucosa. Instead, they should be encouraged to keep their mouth clean and free of irritants.
D) "Brush your teeth for 60 seconds twice daily.": Although maintaining oral hygiene is important, brushing for only 60 seconds may not be sufficient to ensure proper cleaning, especially in the presence of mucositis. It may also be painful, leading to avoidance. A gentler and more thorough approach is often advised, using a soft-bristled toothbrush.
Correct Answer is A
Explanation
A) Photophobia: This is a common symptom associated with meningitis. Inflammation of the meninges can lead to sensitivity to light, making photophobia a significant finding during the assessment of a client with meningitis. This symptom can cause discomfort and may lead clients to avoid bright environments.
B) Intermittent headache: While headaches are a common symptom of meningitis, they are typically severe and persistent rather than intermittent. Clients often report a continuous, severe headache that is different from their usual headaches, which is more indicative of meningitis.
C) Petechiae on the chest: Although petechiae can occur in certain types of meningitis, particularly meningococcal meningitis, it is not a universal finding. The presence of petechiae would suggest a more severe systemic involvement, but it is not expected in every case of meningitis.
D) Bradycardia: This is not a typical finding in meningitis. In fact, tachycardia (increased heart rate) is more commonly seen due to fever and infection. Bradycardia might indicate a different underlying issue and is not expected in the context of meningitis.