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) Lidocaine: Lidocaine is primarily used for the management of ventricular arrhythmias, particularly in cases of ventricular tachycardia or ventricular fibrillation. It is not indicated for treating sinus bradycardia and ST segment elevation.
B) Digoxin: Digoxin is used to treat atrial fibrillation and heart failure but is not appropriate for acute management of sinus bradycardia. In fact, digoxin can potentially worsen bradycardia by increasing vagal tone.
C) Atropine: Atropine is the drug of choice for acute management of symptomatic bradycardia. It works by blocking the effects of the vagus nerve on the heart, which can increase heart rate. Given the client's symptoms of shortness of breath and dizziness, atropine is appropriate to help stabilize their condition.
D) Sotalol: Sotalol is an antiarrhythmic medication used primarily for atrial fibrillation and ventricular arrhythmias. It is not indicated for the treatment of bradycardia and may even exacerbate the condition.
Correct Answer is B
Explanation
A) Check pressure points every 12 hr.: This action is insufficient frequency for a client in skeletal traction. Pressure points should be assessed more frequently, ideally every 2 hours, to prevent skin breakdown and complications related to immobility.
B) Provide the client with a trapeze bar.: This is the most appropriate action. A trapeze bar allows the client to assist with repositioning themselves and helps to reduce strain on the muscles and joints, promoting better mobility while in traction.
C) Instruct the client to use their elbows to reposition.: While this might help the client move slightly, using the elbows alone could lead to strain and discomfort. Proper use of a trapeze bar is a better approach to support safe and effective repositioning.
D) Remove the weights before changing the client's bed linens.: Weights should never be removed without a healthcare provider's order as this can disrupt the alignment and effectiveness of the skeletal traction, potentially causing complications.