The nurse administers atenolol 50 mg PO bid to a client who has coronary artery disease. The nurse understands that the therapeutic effect of this medication for this client is to:

Choice A reason: Preparing for endotracheal intubation and ventilatory support is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with respiratory failure or impending airway obstruction, which are not the case for this client.

Choice B reason: Providing continuous sedation for pain relief is not the action that the nurse should take for a client with thyroid storm. This intervention may worsen the client's condition by suppressing the respiratory drive and lowering the blood pressure. The nurse should administer antithyroid medications, beta blockers, and corticosteroids as prescribed to reduce the thyroid hormone levels and the associated symptoms.

Choice C reason: Initiating cardiac monitoring and assessing for reflex bradycardia is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with hyperkalemia or digoxin toxicity, which are not the case for this client. The nurse should monitor the client's heart rate and rhythm, but not expect a reflex bradycardia, which is a paradoxical slowing of the heart rate in response to a rapid rise in blood pressure.

Choice D reason: Maintaining IV fluid infusion and assessing adequacy of hydration is the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with thyroid storm, as they are at risk of dehydration and electrolyte imbalance due to increased metabolic rate, fever, sweating, vomiting, and diarrhea. The nurse should administer isotonic fluids, such as normal saline, and monitor the client's fluid intake and output, urine specific gravity, and serum electrolytes.

Choice A reason: Limiting the intake of citrus juices is not related to the teaching about hydrochlorothiazide. Citrus juices are rich in vitamin C, which has no significant interaction with hydrochlorothiazide. The client does not need to avoid or limit citrus juices unless they have other medical conditions that require dietary restrictions.

Choice B reason: Eating bananas daily to lower the potassium level is a wrong statement. Bananas are high in potassium, which is a mineral that hydrochlorothiazide can deplete from the body. The client may need to increase their potassium intake or take a potassium supplement to prevent hypokalemia, a condition of low potassium level that can cause muscle weakness, cramps, and arrhythmias.

Choice C reason: Taking the pill each day in the morning is the correct statement. Hydrochlorothiazide is a diuretic that increases the urine output and reduces the blood volume and pressure. The client should take the pill in the morning to avoid nocturia, which is frequent urination at night that can disrupt the sleep quality and increase the risk of falls.

Choice D reason: Taking the pill each day after dinner is not the best statement. Hydrochlorothiazide can cause diuresis, which is increased urine production and excretion. Taking the pill after dinner can lead to nocturia, which is frequent urination at night that can interfere with the sleep cycle and cause fatigue and irritability. The client should take the pill in the morning to prevent nocturia and its complications.