A nurse is collecting data from a client who has Graves' disease. Which of the following images should the nurse identify as an indication that the client is experiencing exophthalmos?

 

A. Blood transfusion: Hepatitis A is not transmitted through blood. Blood transfusions are a risk factor for hepatitis B or C, but hepatitis A is primarily spread via ingestion of contaminated food or water.

B. In utero from mother to infant: Vertical transmission is uncommon with hepatitis A. Unlike hepatitis B, the virus rarely crosses the placenta, so perinatal infection is not a typical mode of transmission.

C. Sexual contact: While sexual contact can transmit certain hepatitis viruses, hepatitis A is not commonly spread sexually. Transmission through sexual activity is much less frequent than fecal-oral exposure.

D. Fecal-to-oral route: Hepatitis A is primarily transmitted via the fecal-oral route, often through ingestion of contaminated food, water, or contact with infected individuals. This mode of transmission is the most common way clients acquire the virus.

A. Hypoglycemia: Phenytoin does not typically lower blood glucose levels, so hypoglycemia is not a common adverse effect. Blood glucose monitoring is not routinely required for clients on phenytoin unless they have an underlying metabolic disorder.

B. Gingival hyperplasia: Phenytoin can cause overgrowth of gum tissue, particularly with long-term use, leading to swelling, bleeding, and discomfort. Good oral hygiene and regular dental care are important to manage and prevent progression. This is a well-documented and common adverse effect of the medication.

C. Ringing of the ears: Tinnitus is more commonly associated with high doses of certain antibiotics or salicylates, not phenytoin. Although phenytoin toxicity can cause neurologic symptoms, ringing in the ears is not a primary concern for routine monitoring.

D. Elevated blood pressure: Phenytoin does not directly raise blood pressure. Blood pressure monitoring is still important for overall health, but hypertension is not an expected adverse effect of this anticonvulsant medication.