The nurse is admitting a client with a thyroid disorder who presents with periorbital edema, cold intolerance, and weight gain. Which intervention should the nurse include in this client's plan of care?

Administer propylthiouracil (PTU).

Provide an electric blanket.

Restrict fluids.

Monitor for hypotension.

Answer and Explanation

The Correct Answer is A

Choice A reason: Propylthiouracil (PTU) is an antithyroid medication used to treat hyperthyroidism, which can present with symptoms such as weight loss and heat intolerance. The symptoms listed (periorbital edema, cold intolerance, and weight gain) suggest hypothyroidism, for which PTU is not indicated.

Choice B reason: Providing an electric blanket may offer comfort for cold intolerance but does not address the underlying thyroid disorder.

Choice C reason: Restricting fluids is not a standard intervention for thyroid disorders and could potentially lead to dehydration.

Choice D reason: Monitoring for hypotension is important in thyroid disorders, especially if the client is on antithyroid medications, which can affect blood pressure. However, the symptoms presented suggest hypothyroidism, where hypotension is less of a concern compared to hyperthyroidism.

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Correct Answer is A

Explanation

Choice A reason: The serum lactate level of 3.9 mmol/L is significantly higher than the normal range of 0.5-2 mmol/L. This is a critical value to report as it indicates a high likelihood of sepsis, which is a life-threatening condition requiring immediate intervention. Elevated lactate levels suggest that the tissues are not adequately oxygenated, a state known as tissue hypoxia, which is a hallmark of sepsis.

Choice B reason: While the vital signs show a slight fever (100°F), the heart rate, respiratory rate, and blood pressure are within normal limits for an adult and do not indicate an immediate life-threatening condition.

Choice C reason: A pulse oximetry reading of 96% on supplemental oxygen is within the acceptable range, indicating adequate oxygen saturation and not a direct sign of sepsis.

Choice D reason: The presence of rhonchi bilaterally suggests airway obstruction due to mucus, which can be associated with pneumonia. However, this finding alone does not carry the same immediate risk of morbidity and mortality as an elevated lactate level indicative of sepsis.

A. Tachycardia and weight gain B. Diarrhea and hypoglycemia C. Hypotension and periorbital edema D. Tremors and dyskinesias

Correct Answer is C

Explanation

Choice A reason: Tachycardia and weight gain are not typically associated with low T4 levels. Tachycardia and weight loss are more commonly seen in hyperthyroidism, where T4 levels would be elevated.

Choice B reason: Diarrhea and hypoglycemia are not directly related to low T4 levels. Diarrhea can be a symptom of hyperthyroidism, while hypoglycemia is not commonly associated with thyroid function.

Choice C reason: Hypotension and periorbital edema are findings that can be associated with hypothyroidism, which is consistent with the low T4 level of 2.9 mcg/dL. Hypothyroidism can lead to reduced cardiac output and systemic vascular resistance, causing hypotension. Periorbital edema is also a common sign of hypothyroidism due to mucopolysaccharide deposition in the skin.

Choice D reason: Tremors and dyskinesias are more commonly associated with hyperthyroidism, not hypothyroidism. Elevated levels of thyroid hormones can lead to these neurological symptoms.

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The nurse is admitting a client with a thyroid disorder who presents with periorbital edema, cold intolerance, and weight gain. Which intervention should the nurse include in this client's plan of care?

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a client admitted for treatment of pneumonia and possible sepsis. Which information is most important for the nurse to report?

Correct Answer is A

Explanation

The nurse caring for a client with thyroid disease notes a current T4 level of 2.9 mcg/dL (normal range: 5-11.5 mcg/dL). Which findings are consistent with this result?

Correct Answer is C

Explanation

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