The nurse is caring for a school-age child with hyperthyroidism (Graves’ disease). Which clinical manifestations should the nurse monitor that may indicate a thyroid storm? (Select all that apply)

Choice A reason:

Hypokalemia, or low potassium levels, is not typically associated with chronic renal failure. In fact, chronic renal failure often leads to hyperkalemia, which is an elevated level of potassium in the blood. This occurs because the kidneys are unable to excrete potassium effectively, leading to its accumulation in the body. Therefore, hypokalemia is not a clinical manifestation of chronic renal failure.

Choice B reason:

Oliguria, or reduced urine output, is a common clinical manifestation of chronic renal failure2. As the kidneys lose their ability to filter and excrete waste products, urine production decreases. This reduction in urine output is a key indicator of declining kidney function and is often observed in children with chronic renal failure. Monitoring urine output is crucial in assessing the progression of the disease and the effectiveness of treatment.

Choice C reason:

Hypotension, or low blood pressure, is not typically seen in chronic renal failure. Instead, hypertension, or high blood pressure, is more commonly associated with chronic renal failure. The kidneys play a crucial role in regulating blood pressure, and when they are not functioning properly, it can lead to an increase in blood pressure. Therefore, hypotension is not a clinical manifestation of chronic renal failure.

Choice D reason:

Massive hematuria, or the presence of a large amount of blood in the urine, is not a typical clinical manifestation of chronic renal failure. While hematuria can occur in some kidney conditions, it is not a defining feature of chronic renal failure. Chronic renal failure is more commonly associated with symptoms such as oliguria, fatigue, and swelling due to fluid retention.

Choice A reason:

Releasing traction every hour to perform skin care: Releasing traction every hour is not recommended as it can disrupt the alignment and healing process of the fractured femur. Skin care is important, but it should be performed without compromising the traction setup.

Choice B Reason:

Releasing traction once every 8 hours to check circulation: While checking circulation is crucial, releasing traction every 8 hours is not necessary and can interfere with the therapeutic benefits of traction. Circulation can be monitored without releasing the traction.

Choice C Reason:

Maintaining continuous traction until 1 hour before the scheduled surgery: Continuous traction is essential to maintain the alignment of the fractured femur. However, there is no need to release traction 1 hour before surgery unless specifically instructed by the surgical team.

Choice D Reason:

Maintaining continuous traction and checking the position of traction: This is the most appropriate action. Continuous traction ensures proper alignment and healing of the fractured femur. Regularly checking the position of traction helps prevent complications and ensures the effectiveness of the treatment.