A nurse is reviewing the medical record for a client who has hypothyroidism and is experiencing myxedema coma. Which of the following findings should the nurse expect?

Fever

Hypernatremia

Hypertension

Hypoglycemia

Answer and Explanation

The Correct Answer is B

A) Fever: Myxedema coma is characterized by hypothermia rather than fever. The client with myxedema coma may experience a lowered body temperature, reflecting the severe hypothyroidism associated with this condition.

B) Hypernatremia: Hypernatremia, or elevated sodium levels, is a common finding in myxedema coma. This occurs due to impaired renal function and decreased aldosterone levels, leading to an imbalance in electrolytes, including sodium.

C) Hypertension: Typically, myxedema coma presents with hypotension rather than hypertension. The condition is associated with decreased cardiac output and low blood pressure, not elevated blood pressure.

D) Hypoglycemia: In myxedema coma, hypoglycemia is not typically expected. Instead, patients may experience hypoglycemia due to reduced metabolic rate and decreased glycogen stores. However, hyperglycemia is more commonly observed in other endocrine disorders, not specifically in myxedema coma.

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Correct Answer is C

Explanation

A) Apples:
Apples are generally considered safe for individuals with gastroesophageal reflux disease (GERD). They are low in acid and do not typically contribute to reflux symptoms, making them a suitable fruit choice.

B) Potatoes:
Potatoes are bland and non-acidic, making them a good option for individuals with GERD. They do not typically trigger reflux symptoms and can be included in a reflux-friendly diet.

C) Tomatoes:
Tomatoes are highly acidic and can significantly aggravate GERD symptoms. Their acidity can weaken the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus, causing discomfort and heartburn.

D) Bananas:
Bananas are low in acid and often recommended for people with GERD. They are gentle on the stomach and do not usually cause reflux symptoms, making them a good dietary choice for managing GERD.

A. Maintain the client on bed rest for 48 hr following surgery. B. Check the tubing for kinks and blood clots at least every 2 hr. C. Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate. D. Remove the catheter if the client reports severe bladder spasms.

Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

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A nurse is reviewing the medical record for a client who has hypothyroidism and is experiencing myxedema coma. Which of the following findings should the nurse expect?

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