A nurse is caring for a client who has Graves' disease and is experiencing a thyroid storm. Which of the following actions is the nurse's priority?

Provide a cooling blanket.

Monitor the client's cardiac rhythm.

Administer 0.9% sodium chloride IV.

Obtain the client's blood glucose.

Answer and Explanation

The Correct Answer is B

A.   While a cooling blanket may be indicated to reduce fever associated with a thyroid storm, the priority lies in monitoring the cardiac rhythm for potential life-threatening complications such as tachycardia or arrhythmias.
B.   Thyroid storm can precipitate severe cardiac complications, making continuous monitoring of the client's cardiac rhythm imperative to detect any abnormalities promptly.
C.   Administering IV fluids may be necessary to address dehydration, but it is not the priority over monitoring the cardiac rhythm.
D.   While monitoring blood glucose levels is important, it is not the immediate priority in managing a thyroid storm.

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Correct Answer is A

Explanation

A: A client who is scheduled for a colonoscopy and is taking sodium phosphate requires follow-up care because sodium phosphate can cause colonic mucosal damage and electrolyte imbalances that may affect the safety and accuracy of the colonoscopy. Sodium phosphate is a bowel preparation agent that empties the colon before the procedure, but it can also cause dehydration, kidney injury, and cardiac arrhythmias.
B: Induration following a Mantoux test indicates a reaction that may suggest tuberculosis exposure, but this is an expected result that requires assessment rather than immediate follow-up.
C: Bumetanide is a diuretic, and an increase in urination is an expected effect of this medication.
D: Warfarin is considered safe during lactation since it is not excreted in breastmilk to any measurable degree.

A. Obtain a blood specimen for ABG analysis. B. Apply 100% humidified oxygen. C. Obtain a baseline ECG. D. Insert an 18-gauge IV catheter.

Correct Answer is B

Explanation

A. Obtain a blood specimen for ABG analysis. Important, but not the first action.

B. In a client with burn injuries experiencing signs of airway compromise (drooling, hoarseness), the first action should be to ensure adequate oxygenation. Applying 100% humidified oxygen can help manage potential airway edema.
C. Obtain a baseline ECG. Necessary for monitoring but secondary to securing the airway.
D. Insert an 18-gauge IV catheter. Essential for fluid resuscitation and medication administration, but after ensuring adequate oxygenation.

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A nurse is caring for a client who has Graves' disease and is experiencing a thyroid storm. Which of the following actions is the nurse's priority?

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