A 52-year-old client reports weight gain and tiredness. On assessment, her vital signs are blood pressure 124/74 mm/hg, pulse rate 52 beats/min. respiratory rate 20 breaths/minute, and temperature 98.0 F. Laboratory results show low thyroxine (T4) and triiodothyronine (T3) levels. The nurse knows these symptoms are associated with which condition?

A. Hypothyroidism: Hypothyroidism is characterized by symptoms such as weight gain, fatigue, dry skin, and cold intolerance. The teen's symptoms of weight loss, nervousness, and bulging eyes are not typical of hypothyroidism.

B. Juvenile autoimmune thyroiditis: Juvenile autoimmune thyroiditis is typically associated with hypothyroidism and does not present with symptoms like weight loss, nervousness, or bulging eyes. It is more often characterized by fatigue, cold intolerance, and weight gain.

C. Hashimoto thyroid disease: Hashimoto's disease is an autoimmune disorder that often leads to hypothyroidism. The symptoms described (weight loss, nervousness, bulging eyes) do not align with Hashimoto's disease, which is generally linked to an underactive thyroid.

D. Graves' Disease: Graves' disease is a type of hyperthyroidism often characterized by weight loss, nervousness, bulging eyes (exophthalmos). The symptoms align with the presentation of this teen, and the low TSH level further supports the diagnosis.

A. The nurse will monitor the client's blood glucose levels four (4) times a day: This is important, but it is an intervention rather than a goal. A goal should be measurable and focused on the client's outcome, such as maintaining specific glucose levels.

B. The client will demonstrate appropriate insulin injection techniques: This is a good educational goal, but it does not directly address the immediate concern. The problem states noncompliance, implying the client knows how to inject but isn't doing it consistently.

C. The client will maintain normal kidney function with 30-ml/hr urine output: While monitoring kidney function is important in diabetes, this goal does not address the immediate risk of hyperglycemia. Urine output is not the primary indicator of hyperglycemia.

D. The client will have a blood glucose level between 60-110 mg/dl at 1600: This short-term goal is specific, measurable, and time-bound. It addresses the desired outcome of maintaining blood glucose within a normal range, which addresses hyperglycemia due to noncompliance.