A nurse is assessing a patient admitted with hyperthyroidism.
The patient reports a weight loss of 5.4 kg (12 lb) in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness.Which of the following actions should the nurse take to prevent a thyroid crisis?

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.

Choice A rationale
Providing information is a communication technique where the nurse gives the patient factual and relevant information. In this scenario, the nurse is not providing information but rather seeking to understand the patient’s feelings.
Choice B rationale
Summarizing is a communication technique where the nurse reviews the main points of the conversation to ensure understanding. In this scenario, the nurse is not summarizing the conversation but rather seeking to understand the patient’s feelings.

Choice C rationale
Clarification is a communication technique where the nurse seeks to understand the patient’s message by asking for more information or for elaboration on a point. In this scenario, the nurse is using clarification by restating the patient’s concern in a different way to confirm their understanding.
Choice D rationale
Confrontation is a communication technique where the nurse addresses observed discrepancies or conflicts in the patient’s behavior or communication. In this scenario, the nurse is not confronting the patient but rather seeking to understand their feelings.