A nurse is reviewing the medical records of clients on a hospital floor. Which client would the nurse expect is most at risk for hyperthyroidism?

Choice A Reason:
While performing range of motion exercises is important for maintaining joint function and preventing stiffness, it is not the first action a nurse should take. Range of motion exercises should only be performed after ensuring that there is no compromise in circulation or nerve function.

Choice B Reason:
Checking capillary refill is the correct first action. This quick test assesses the blood flow to the extremity and can indicate if there is any vascular obstruction. A delayed capillary refill time, which is more than 2 seconds, could signify compromised circulation and necessitate immediate intervention.

Choice C Reason:
Discussing cast care is important for client education and preventing complications such as skin breakdown and infection. However, it is not the first priority. The nurse should first ensure the client's physiological stability before providing education.

Choice D Reason:
Managing pain is a critical component of nursing care, especially for clients with fractures. However, the assessment of circulation takes precedence over pain management. Once it is established that there is no immediate threat to the limb's viability, pain management should be addressed promptly.

Choice A reason:
Informatics involves the use of information technology in healthcare, which is essential for managing patient data and improving communication. However, while informatics supports various aspects of patient care, it is not the primary concern during the perioperative period. The focus during this time is on ensuring the client's immediate well-being and preventing harm.

Choice B reason:
Quality improvement is a continuous process of identifying and implementing changes to improve patient care and outcomes. While it is a critical component of nursing practice, the priority in the perioperative period is the safety of the client, which is a more immediate concern.

Choice C reason:
Safety is the most critical QSEN competency during the perioperative period. This period involves significant risks due to anesthesia, surgical procedures, and potential complications. Ensuring the client's safety by preventing errors, reducing the risk of harm, and maintaining a sterile environment is paramount.

Choice D reason:
Evidence-based practice involves using the best current evidence to make informed decisions about patient care. While it is crucial for guiding clinical practice, the immediate priority in the perioperative period is ensuring the client's safety through vigilant monitoring and intervention.