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.)

The correct answer is choice B: Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.

Choice A rationale:

Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy. This choice is incorrect because it includes "aortic hypertrophy" and "left ventricular hypertrophy," which are not components of the tetralogy of Fallot. Aortic hypertrophy is not a recognized structural defect in tetralogy of Fallot, and left ventricular hypertrophy is not a characteristic feature of this congenital heart condition.

Choice B rationale:

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. This is the correct choice. Tetralogy of Fallot is characterized by four specific structural defects: pulmonic stenosis (narrowing of the pulmonary valve), ventricular septal defect (hole between the right and left ventricles), overriding aorta (aorta positioned over the ventricular septal defect, receiving blood from both ventricles), and right ventricular hypertrophy (enlargement of the right ventricle due to increased workload).

Choice C rationale:

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. This choice is incorrect because it includes "aortic stenosis," which is not part of the tetralogy of Fallot. In tetralogy of Fallot, the stenosis occurs at the pulmonary valve, not the aortic valve.

Choice D rationale:

Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy. This choice is incorrect. While "overriding aorta" is present in tetralogy of Fallot, "atrial septal defect" and "left ventricular hypertrophy" are not part of this condition. Atrial septal defects involve a hole between the two atria, not the ventricles, and left ventricular hypertrophy is not typically seen in tetralogy of Fallot.

The correct answer is Choice A.Choice A rationale:Vomiting is a common sign of digoxin toxicity. It occurs due to the drug's effects on the gastrointestinal system, which can lead to nausea and vomiting as the body attempts to expel the toxin. This symptom is particularly significant as it can indicate elevated digoxin levels that may require medical intervention.Choice B rationale:Tachycardia, or an increased heart rate, can occur with digoxin toxicity; however, it is more commonly associated with inadequate therapeutic levels rather than toxicity itself. Digoxin usually causes bradycardia (a slower heart rate) when at therapeutic levels, making tachycardia less indicative of toxicity.Choice C rationale:Bradypnea, or slow breathing, is not a typical sign of digoxin toxicity. While respiratory issues can arise from various conditions, they are not specifically linked to digoxin levels. Monitoring respiratory rate is essential in clinical settings but does not directly correlate with digoxin toxicity.Choice D rationale:Seizures are not a common sign of digoxin toxicity. While severe cases might lead to neurological symptoms due to electrolyte imbalances or other complications, seizures are not typically associated with digoxin overdose. Instead, they may suggest other underlying issues requiring evaluation.