A nurse is teaching a client about the proper way to take levothyroxine. Which instruction should be included in the teaching plan? "Take levothyroxine:

A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.

A. Developing a caring rapport with clients is correct. Building a strong, trusting relationship with clients can help reduce the likelihood of miscommunication or misunderstandings, which could lead to negligence. A caring rapport promotes effective communication and patient satisfaction.
B. Failing to notify the provider of a change in the client's condition is incorrect. Failing to notify the provider when a client's condition changes is an example of negligence. Nurses must report any changes in the patient's condition promptly to prevent harm.
C. Following standards of care is correct. Adhering to established standards of care is essential to ensure that the nurse provides safe and competent care. Deviating from these standards can lead to negligence and potential liability.
D. Communicate effectively with other health team members is correct. Effective communication among healthcare team members helps ensure that everyone is informed about the patient's condition and care plan. Poor communication is a common cause of medical errors and negligence.
E. Fully documenting assessments, interventions, and evaluations is correct. Proper documentation is a legal record of the care provided. Thorough, accurate documentation helps protect nurses from liability and serves as evidence of care in the event of a legal dispute.
F. Failing to document care provided is incorrect. Failure to document the care provided is a form of negligence. Documentation is essential for patient safety and for providing a clear, detailed record of care, which protects both the nurse and the patient.
G. Ignoring facility policies and procedures is incorrect. Ignoring facility policies and procedures increases the risk of negligence and potential harm to patients. Policies and procedures are put in place to ensure the delivery of safe and effective care, and failure to follow them could lead to liability.