A nurse is reinforcing teaching with a client about dietary intake to promote wound healing.
Which of the following vitamins should the nurse recommend?

Choice A rationale

Exophthalmos is characterized by abnormal protrusion or bulging of the eyes due to retro-orbital tissue swelling and inflammation associated with Graves’ disease. This condition is a hallmark symptom of Graves’ ophthalmopathy.

Choice B rationale

Sunken eyes are not indicative of exophthalmos and are typically associated with dehydration or aging, rather than retro-orbital tissue changes as seen in Graves’ disease.

Choice C rationale

Eyelid swelling might occur in various conditions, such as allergies or infections, but it does not specifically point to exophthalmos or Graves’ disease-related complications.

Choice D rationale

Redness and watering of the eyes are non-specific symptoms that could occur in conjunctivitis or dry eye syndrome but do not define exophthalmos uniquely.

Choice A rationale

Pain patches containing medications like fentanyl are designed for continuous absorption over 72 hours and should not be removed at bedtime. Removing the patch prematurely could lead to a sudden drop in medication levels, compromising pain control. The pharmacokinetics of transdermal patches ensure a steady release of analgesic agents without requiring frequent application.

Choice B rationale

Around-the-clock analgesia provides consistent plasma drug levels, ensuring better pain control compared to as-needed dosing. By preventing peaks and troughs in medication levels, this approach enhances efficacy and improves the client’s quality of life. Studies confirm this approach reduces breakthrough pain in terminal cancer patients.

Choice C rationale

Intramuscular injections are not the preferred route for long-term pain management due to their variable absorption, potential for tissue damage, and patient discomfort. Oral, transdermal, or intravenous routes are safer, more effective options for sustained analgesia.

Choice D rationale

Tolerance, a normal physiological response, does not necessitate dose reduction but rather dose adjustment to maintain therapeutic effects. Reducing the dose can result in inadequate pain relief and increased patient suffering. Evidence supports dose titration based on pain severity and patient needs.