A nurse is assessing a client with suspected hyperthyroidism. Which of the following findings should the nurse expect?

Choice A reason: Methylprednisolone, a corticosteroid, reduces inflammation in anaphylaxis by inhibiting immune responses. However, its onset is slow, taking hours to act, making it unsuitable as the first-line treatment for acute anaphylactic shock. It is used as an adjunct to stabilize symptoms after epinephrine addresses immediate life-threatening bronchoconstriction and hypotension.

Choice B reason: Epinephrine is the first-line treatment for anaphylactic shock. It acts rapidly via alpha- and beta-adrenergic receptors to reverse bronchoconstriction, vasodilation, and hypotension. It constricts blood vessels, increases cardiac output, and relaxes airway smooth muscles, alleviating life-threatening symptoms like airway obstruction and shock, making it critical for immediate administration.

Choice C reason: Dobutamine, a beta-agonist, enhances cardiac contractility and is used in cardiogenic shock. It does not address the histamine-mediated vasodilation, bronchoconstriction, or angioedema in anaphylaxis. Its use could worsen hypotension by increasing cardiac demand without correcting the underlying immune-mediated mechanisms, making it inappropriate for this emergency.

Choice D reason: Furosemide, a diuretic, treats fluid overload in conditions like heart failure. In anaphylactic shock, it would exacerbate hypotension by reducing intravascular volume, worsening tissue perfusion. Anaphylaxis involves histamine-induced vascular leak, not fluid overload, so furosemide is contraindicated and would not address the acute airway or cardiovascular symptoms.

Choice A reason: A nasal cannula at 2 L/min delivers low-flow oxygen (24-28% FiO2), insufficient for a COPD exacerbation, where hypoxemia is severe due to airway obstruction and ventilation-perfusion mismatch. It cannot provide precise, high FiO2 needed to correct hypoxia while avoiding excessive oxygen, which may suppress respiratory drive in COPD patients.

Choice B reason: A simple face mask at 10 L/min delivers 40-60% FiO2 but lacks precision in oxygen concentration. In COPD, excessive oxygen can reduce respiratory drive, causing CO2 retention due to the hypoxic drive mechanism. This makes it less suitable than a Venturi mask, which provides controlled oxygen delivery.

Choice C reason: A non-rebreather mask at 15 L/min delivers near 100% FiO2, which is excessive for COPD exacerbation. High oxygen levels can suppress the hypoxic drive in COPD patients, leading to hypercapnia and respiratory failure. Controlled oxygen delivery is needed to balance oxygenation and CO2 retention risks.

Choice D reason: A Venturi mask at 40% FiO2 delivers precise oxygen concentrations, ideal for COPD exacerbations. It balances hypoxemia correction with the risk of CO2 retention by providing controlled FiO2. This prevents suppression of the hypoxic respiratory drive while ensuring adequate oxygenation, making it the preferred method for acute COPD management.