A patient presents with a thyroid storm. Which of the following interventions is most appropriate to initially manage this condition?

Administer propranolol intravenously.

Administer dextrose 50% intravenously.

Administer levothyroxine orally.

Administer insulin to control hyperglycemia.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Administering propranolol intravenously is the most appropriate initial intervention for managing a thyroid storm. Thyroid storm is a life-threatening condition characterized by severe hyperthyroidism, leading to symptoms such as tachycardia, hypertension, and hyperthermia. Propranolol, a non-selective beta-blocker, helps control these symptoms by reducing heart rate and blood pressure. Additionally, propranolol inhibits the peripheral conversion of T4 to T3, the more active form of thyroid hormone, thereby reducing the overall thyroid hormone activity. This makes it a critical first step in stabilizing the patient.

Choice B Reason:

Administering dextrose 50% intravenously is not the most appropriate initial intervention for thyroid storm. Dextrose 50% is typically used to treat severe hypoglycemia by rapidly increasing blood glucose levels. While maintaining adequate glucose levels is important, it does not address the primary issue of excessive thyroid hormone activity in thyroid storm.

Choice C Reason:

Administering levothyroxine orally is inappropriate in the context of thyroid storm. Levothyroxine is a synthetic form of T4 used to treat hypothyroidism, not hyperthyroidism. Administering it in a thyroid storm would exacerbate the condition by increasing the levels of thyroid hormone in the body.

Choice D Reason:

Administering insulin to control hyperglycemia is not the primary intervention for thyroid storm. While hyperglycemia can occur in thyroid storm due to increased metabolic activity, the immediate priority is to control the excessive thyroid hormone activity. Insulin administration would be secondary to stabilizing the patient’s thyroid function.

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Correct Answer is A

Explanation

Choice A Reason:

Stopping the transfusion immediately and notifying the healthcare provider is the most appropriate initial action when a transfusion reaction is suspected. This action helps to prevent further complications and allows for prompt evaluation and management of the reaction. The nurse should also keep the IV line open with normal saline to maintain venous access.

Choice B Reason:

Administering antipyretics and continuing the transfusion is not appropriate. Continuing the transfusion could exacerbate the reaction and lead to more severe complications. The priority is to stop the transfusion and assess the patient before considering any further interventions.

Choice C Reason:

Slowing down the rate of the transfusion and reassessing in 30 minutes is not a safe approach. Any signs of a transfusion reaction, such as chills and fever, require immediate cessation of the transfusion. Delaying intervention could result in worsening of the patient’s condition.

Choice D Reason:

Continuing the transfusion and monitoring the patient closely is not appropriate. Immediate cessation of the transfusion is necessary to prevent further exposure to the potentially harmful blood product. Monitoring alone is insufficient without stopping the transfusion.

A. Sedentary lifestyle B. Triglyceride level of 100 mg/dL C. Recent viral infection D. Blood glucose of 98 mg/dL

Correct Answer is A

Explanation

Choice A Reason:

A sedentary lifestyle is a significant risk factor for developing type 2 diabetes mellitus. Lack of physical activity can lead to obesity, which is a major contributor to insulin resistance. Regular physical activity helps to maintain a healthy weight, improve insulin sensitivity, and reduce the risk of developing type 2 diabetes.

Choice B Reason:

A triglyceride level of 100 mg/dL is within the normal range and is not considered a risk factor for type 2 diabetes. Elevated triglyceride levels (above 150 mg/dL) are associated with an increased risk of developing type 2 diabetes, but a level of 100 mg/dL does not indicate an increased risk.

Choice C Reason:

A recent viral infection is not a recognized risk factor for type 2 diabetes While certain viral infections can trigger autoimmune responses leading to type 1 diabetes, they are not linked to the development of type 2 diabetes, which is primarily influenced by lifestyle factors and genetics.

Choice D Reason:

A blood glucose level of 98 mg/dL is within the normal range for fasting blood glucose and does not indicate an increased risk for type 2 diabetes. Prediabetes is diagnosed when fasting blood glucose levels are between 100 and 125 mg/dL, and diabetes is diagnosed at levels of 126 mg/dL or higher. Therefore, a blood glucose level of 98 mg/dL is not a risk factor for type 2 diabetes.

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A patient presents with a thyroid storm. Which of the following interventions is most appropriate to initially manage this condition?

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