A nurse is caring for a client who has an arterial line inserted in the radial artery. Which of the following actions should the nurse take?

Choice A reason: Hypothyroidism requires lifelong levothyroxine because the thyroid gland doesn’t regain function in most cases, such as Hashimoto’s disease. Stating several months misleads the client, implying a temporary treatment, which is inaccurate. This chronic condition demands continuous hormone replacement to maintain metabolism, energy, and organ function. Temporary therapy applies to transient conditions, not primary hypothyroidism, so this statement fails to reflect the long-term nature of management needed.

Choice B reason: Hypothyroidism slows metabolism due to low thyroid hormone levels, reducing basal metabolic rate and calorie burning. This leads to weight gain as energy expenditure drops, even with unchanged diet, a common symptom. Educating clients about this helps them understand and manage expectations, linking it to the condition’s physiology. It’s a key teaching point, as weight gain often prompts diagnosis and motivates adherence to levothyroxine therapy.

Choice C reason: Laboratory tests like TSH and free T4 are essential to monitor levothyroxine’s effectiveness in hypothyroidism, ensuring the dose restores euthyroid status. These tests, typically done every 6-12 weeks initially then annually, guide adjustments to prevent under- or over-treatment. Including this in teaching empowers clients to participate in their care, understanding why follow-ups matter. It reflects standard practice for managing this endocrine disorder accurately.

Choice D reason: Increased perspiration is a hyperthyroidism symptom, where excess thyroid hormone accelerates metabolism, raising body heat. Hypothyroidism, conversely, causes cold intolerance and dry skin due to slowed metabolism, reducing sweat production. This statement contradicts hypothyroidism’s physiology, misinforming the client about expected symptoms. Correct teaching would highlight cold sensitivity instead, aligning with the condition’s impact on thermoregulation and skin.

Choice E reason: Hypothyroidism slows gastrointestinal motility due to decreased thyroid hormone, often causing constipation as a complication. A high-fiber diet increases bulk and promotes bowel movements, preventing this issue. Teaching this dietary adjustment addresses a common, manageable symptom, improving quality of life. It’s a scientifically supported recommendation, as fiber counteracts the sluggish digestion typical in hypothyroid states, making it vital education.

Choice A reason: A parent with type 2 diabetes indicates a genetic risk for metabolic issues, possibly relevant to liver disease progression, like NAFLD. However, it’s historical data, not an immediate threat to transplant success. The priority lies with factors affecting post-operative care, like adherence, over family history. This statement, while useful, isn’t urgent for reporting now.

Choice B reason: Childhood asthma history suggests past respiratory issues, potentially complicating anesthesia or recovery, but if resolved, it’s low priority. End-stage liver disease focuses on hepatic function, not dormant lung conditions. Without current symptoms, this doesn’t impact transplant candidacy urgently, making it less critical than adherence concerns.

Choice C reason: Poor medication adherence is a red flag for transplant listing, as post-operative immunosuppressants prevent rejection, requiring strict compliance. Non-adherence risks graft failure, a life-threatening outcome in end-stage liver disease. This statement demands immediate provider attention to assess candidacy and plan interventions, prioritizing it over other concerns here.

Choice D reason: Lack of family support affects emotional coping and post-transplant care logistics, potentially stressing recovery, but it’s not an immediate medical risk. Adherence to medications directly impacts survival, outweighing psychosocial factors in urgency. This statement, while relevant, doesn’t necessitate urgent reporting compared to compliance issues.