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)
Vomiting
Constipation
Tachycardia
Hypotension
Correct Answer : A,C
The correct answer is a. Vomiting, c. Tachycardia.
Choice A: Vomiting
Vomiting is a common symptom of thyroid storm. Thyroid storm is a life-threatening condition that occurs when the thyroid gland releases a large amount of thyroid hormone in a short period. This sudden surge in thyroid hormone can cause severe metabolic disturbances, leading to symptoms such as vomiting. Vomiting can result from the body’s attempt to cope with the excessive thyroid hormone levels, which can affect the gastrointestinal system.
Choice B: Constipation
Constipation is not typically associated with thyroid storm. In fact, hyperthyroidism, including thyroid storm, usually causes an increase in bowel movements or diarrhea due to the accelerated metabolism. Constipation is more commonly associated with hypothyroidism, where the thyroid gland is underactive and slows down bodily functions.
Choice C: Tachycardia
Tachycardia, or a rapid heart rate, is a hallmark symptom of thyroid storm. The excessive thyroid hormones increase the body’s metabolic rate, leading to an increased demand for oxygen and nutrients. To meet this demand, the heart rate increases significantly, often exceeding 140 beats per minute. This rapid heart rate can be dangerous and requires immediate medical attention.
Choice D: Hypotension
Hypotension, or low blood pressure, is not a typical symptom of thyroid storm. Instead, thyroid storm often causes hypertension (high blood pressure) due to the increased metabolic activity and the body’s heightened demand for oxygen and nutrients. The cardiovascular system responds by increasing blood pressure to ensure adequate blood flow to vital organs.
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Related Questions
Correct Answer is B
Explanation
Choice A reason:
Basketball, while a popular sport, involves a significant amount of physical contact and the risk of falls and injuries1. For children with hemophilia, engaging in contact sports can increase the risk of bleeding episodes and joint damage. Therefore, basketball is not the most recommended sport for children with hemophilia.
Choice B reason:
Swimming is highly recommended for children with hemophilia because it is a low-impact sport that provides excellent cardiovascular exercise without putting undue stress on the joints. The buoyancy of the water supports the body, reducing the risk of injuries and bleeding episodes. Swimming also helps improve muscle strength and flexibility, which can be beneficial for overall health and well-being.
Choice C reason:
Soccer, like basketball, involves a lot of running, physical contact, and the potential for falls and injuries. These factors make soccer a less suitable sport for children with hemophilia, as it can increase the risk of bleeding and joint damage. Therefore, soccer is not the most recommended sport for children with hemophilia.
Choice D reason:
Skating, whether roller skating or ice skating, carries a risk of falls and injuries. While it can be a fun and enjoyable activity, the potential for accidents makes it less suitable for children with hemophilia. The risk of bleeding episodes and joint damage is higher with activities that involve a significant risk of falls.
Correct Answer is C
Explanation
Choice A reason:
Weight gain is not a primary concern in the management of hypothyroidism in infancy. While hypothyroidism can lead to weight gain due to a slower metabolism, the more critical issue is the impact on brain development. Early and adequate treatment of hypothyroidism is essential to prevent intellectual disabilities and ensure normal neurocognitive outcomes.
Choice B Reason:
Rapid gut motility and diarrhea are not typical symptoms of hypothyroidism. In fact, hypothyroidism is more commonly associated with constipation due to a slower metabolism. Therefore, this choice is not relevant to the prompt management of hypothyroidism in infancy.
Choice C Reason:
Infancy is indeed a critical period for brain development. Untreated hypothyroidism during this time can lead to severe intellectual disabilities and developmental delays. Early diagnosis and treatment with thyroid hormone replacement are crucial to ensure normal brain development and cognitive function.
Choice D Reason:
Hyperactivity and irritability are not common symptoms of hypothyroidism. In fact, hypothyroidism often leads to lethargy and decreased activity levels. Therefore, this choice is not relevant to the prompt management of hypothyroidism in infancy.
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