The nurse is assessing a patient with a history of Graves' disease. The assessment is in the chart below. Which interventions will the nurse include in the plan of care? (Select All That Apply)

Assessment:

Respiratory Rate: 28 breaths/minute

Heart rate: 145 beats/minute and irregular

Temperature: 102.2°F (39°C)

Blood pressure: 167/80 mmHg

Level of consciousness: Decreased

Apply a hypothermia blanket.

Administer humidified oxygen.

Administer aspirin 325 mg orally.

Administer D5NS intravenous infusion.

Administer propylthiouracil.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Applying a hypothermia blanket is appropriate for managing hyperthermia in a patient with Graves' disease. Elevated temperatures (fever) are common in thyroid storm, a severe complication of Graves' disease. Using a hypothermia blanket helps reduce the body temperature and prevent further complications.

Choice B reason: Administering humidified oxygen is important for supporting respiratory function in a patient with increased respiratory rate and decreased level of consciousness. Humidified oxygen can help alleviate respiratory distress and improve oxygenation.

Choice C reason: Administering aspirin 325 mg orally is not recommended for patients with hyperthyroidism or thyroid storm. Aspirin can increase free thyroid hormone levels by displacing thyroid hormone from its binding proteins, potentially worsening the patient's condition. Acetaminophen is a safer alternative for managing fever in these patients.

Choice D reason: Administering D5NS intravenous infusion is appropriate for managing dehydration and electrolyte imbalances in a patient with thyroid storm. This intervention helps maintain fluid balance and provides dextrose for energy.

Choice E reason: Administering propylthiouracil is a key intervention for managing thyroid storm. Propylthiouracil inhibits thyroid hormone synthesis and peripheral conversion of T4 to T3, helping to reduce thyroid hormone levels and alleviate symptoms.

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Correct Answer is ["B","C"]

Explanation

Choice A reason: Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and underlying bone. It is not directly associated with corticosteroid treatment. Osteoarthritis develops due to wear and tear over time, and while corticosteroids are used to manage inflammation, they do not cause osteoarthritis.

Choice B reason: Osteoporosis is a potential complication of long-term corticosteroid use. Corticosteroids can interfere with bone formation and increase the rate of bone resorption, leading to decreased bone density and an increased risk of fractures. Patients on long-term corticosteroid therapy should be monitored for signs of osteoporosis, and preventive measures such as calcium and vitamin D supplementation may be recommended.

Choice C reason: Hyperglycaemia, or elevated blood glucose levels, is a common side effect of corticosteroid therapy. Corticosteroids can increase insulin resistance and promote glucose production in the liver, leading to higher blood sugar levels. Patients with diabetes or those at risk for diabetes should be closely monitored for changes in their blood glucose levels when on corticosteroid therapy.

Choice D reason: Mucositis, or inflammation of the mucous membranes, is not a typical complication of corticosteroid therapy. Mucositis is more commonly associated with chemotherapy or radiation therapy used in cancer treatment. While corticosteroids can affect the immune system, they do not directly cause mucositis.

A. The patient is increasingly drowsy and hard to arouse. B. The patient's feet and hands are covered with red, raised purpura.

Correct Answer is A

Explanation

Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.

Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient diagnosed with rheumatoid arthritis (R

Correct Answer is ["B","C"]

Explanation

The nurse is caring for a patient with idiopathic thrombocytopenic purpura (ITP) whose platelet count is 10,000/mm³. What assessment finding will the nurse report to the provider immediately?

Correct Answer is A

Explanation

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