A nurse is assessing a client for potential complications related to obesity. Which condition is the client most at risk for due to obesity?

Choice A reason: Acetaminophen reduces fever by acting on the hypothalamic thermoregulatory center but is ineffective for heat stroke, a hyperthermic emergency caused by environmental heat overload. It does not address core temperature elevation or systemic effects like dehydration and organ dysfunction, making it inappropriate for immediate heat stroke management.

Choice B reason: Removing the client’s clothing facilitates evaporative and convective cooling, critical in heat stroke where core body temperature exceeds 40°C. This intervention enhances heat dissipation from the skin, reducing the risk of organ damage from hyperthermia. It is a primary nursing action to lower body temperature effectively and safely.

Choice C reason: Placing a client with heat stroke in a hot bath would exacerbate hyperthermia, worsening organ damage and cardiovascular strain. Heat stroke requires rapid cooling via cold water immersion or evaporative methods, not additional heat exposure, making this intervention dangerous and contraindicated in this life-threatening condition.

Choice D reason: Encouraging oral fluids like cold water is inappropriate for a lethargic heat stroke patient, who may have impaired swallowing or consciousness, risking aspiration. Intravenous fluids are preferred to correct dehydration and electrolyte imbalances safely, as oral intake does not address the urgent need for rapid cooling and systemic stabilization.

Choice A reason: An ileal conduit is typically a permanent procedure for bladder cancer after cystectomy, as the bladder is removed. Reversibility is rare and depends on specific circumstances, not guaranteed. This statement is inaccurate, as it falsely suggests that ileal conduits are always temporary and reversible.

Choice B reason: Diverting urine to the sigmoid colon describes a ureterosigmoidostomy, not an ileal conduit. In an ileal conduit, urine is diverted through an ileal segment to an abdominal stoma, not the rectum. This statement is inaccurate, as it describes a different urinary diversion procedure.

Choice C reason: An ileal conduit involves diverting urine from the ureters through a segment of ileum to a stoma on the abdomen, where urine is collected in an external pouch. This is the standard procedure for bladder cancer post-cystectomy, making this statement accurate and descriptive of the ileal conduit.

Choice D reason: An ileal conduit does not create an opening in the bladder; the bladder is often removed in bladder cancer. Urine is diverted from the ureters to a stoma, bypassing the bladder. This statement is inaccurate, as it misrepresents the anatomical changes in an ileal conduit.