A nurse is assessing a client who has Graves’ disease. The nurse should expect which of the following laboratory results?

Choice A: He is NPO until the speech-language pathologist performs a swallowing evaluation.

This is the most appropriate response. NPO stands for “nil per os,” which means nothing by mouth. After a stroke, it is crucial to assess the patient’s ability to swallow safely to prevent aspiration, which can lead to pneumonia and other complications. A speech-language pathologist is trained to evaluate swallowing function and determine the safest diet for the patient. Until this evaluation is completed, the patient should not consume any food or liquids.

Choice B: Be sure to sit him up when you are feeding him to make him feel more natural.

While sitting the patient up during feeding is important to reduce the risk of aspiration, it is not sufficient on its own. Without a proper swallowing evaluation, feeding the patient could still pose significant risks. Therefore, this choice is not the most appropriate response.

Choice C: You may give him a full-liquid diet, but please avoid solid foods until he gets stronger.

A full-liquid diet might seem like a safer option, but without a swallowing evaluation, there is still a risk of aspiration. The patient’s ability to handle even liquids needs to be assessed by a professional before any oral intake is allowed.

Choice D: Just be sure to add some thickener in his liquids to prevent choking and aspiration.

Thickening liquids can help manage dysphagia, but this should only be done after a swallowing evaluation has determined the appropriate consistency. Administering thickened liquids without an evaluation could still result in aspiration if the patient has severe swallowing difficulties.

Choice A Reason:

A 42-year-old man with gastroesophageal reflux disease (GERD) is not at the highest risk for obstructive sleep apnea (OSA). While GERD can be associated with OSA, it is not a primary risk factor. The main risk factors for OSA include obesity, age, and anatomical features that can obstruct the airway. Therefore, this individual is not at the greatest risk compared to others.

Choice B Reason:

A 55-year-old woman who is 50 lb (23 kg) overweight is at significant risk for developing OSA. Obesity is one of the most critical risk factors for OSA because excess weight can lead to fat deposits around the upper airway, which can obstruct breathing during sleep. Additionally, being overweight increases the likelihood of other conditions that can exacerbate OSA, such as hypertension and metabolic syndrome.

Choice C Reason:

A 20-year-old woman who is 8 months pregnant may experience temporary sleep disturbances, including snoring and mild sleep apnea, due to hormonal changes and increased abdominal pressure. However, pregnancy-related sleep apnea is usually transient and resolves after childbirth. Therefore, while she may have an increased risk during pregnancy, it is not as significant as the risk posed by obesity.

Choice D Reason:

A 73-year-old man with type 2 diabetes mellitus has an increased risk of OSA, as diabetes is associated with obesity and metabolic syndrome, which are risk factors for OSA. However, the presence of diabetes alone does not pose as high a risk as obesity. Therefore, while this individual is at risk, it is not as high as the risk associated with being significantly overweight.