What are clinical manifestations of hypothyroidism? (Select all that apply)

Choice A reason: Achalasia increases aspiration risk due to esophageal dysmotility. Oropharyngeal suctioning equipment at the bedside ensures airway safety, making this a critical intervention to prioritize in the care plan.

Choice B reason: Small, frequent meals reduce esophageal pressure in achalasia, easing swallowing and minimizing regurgitation. This dietary adjustment is essential for symptom management, making it a correct intervention to prioritize.

Choice C reason: Thickened fluids only may not be necessary; achalasia patients can often manage various consistencies with proper positioning. Other interventions like suctioning and small meals are more critical, so this is incorrect.

Choice D reason: Antiemetics before meals reduce nausea and vomiting, common in achalasia due to food retention. This improves patient comfort and nutrition, making it a correct intervention to prioritize in care.

Choice E reason: Elevating the head of the bed prevents regurgitation and aspiration in achalasia, especially during sleep. This positioning is a key safety measure, making it a correct intervention to prioritize.

Choice A reason: Loss of short-term memory is a hallmark of Alzheimer’s disease, as seen in the patient’s difficulty recalling recent events. This reflects early hippocampal damage, impairing new memory formation, making it a correct clinical manifestation for this diagnosis.

Choice B reason: Alzheimer’s disease is the most likely diagnosis, given progressive memory loss, word-finding difficulties, and an MMSE score of 20/30 in a 65-year-old. These symptoms align with Alzheimer’s neurodegenerative pattern, making this the correct diagnosis.

Choice C reason: Vascular dementia typically presents with stepwise cognitive decline and focal neurological signs, often with vascular risk factors. The patient’s gradual memory loss without such history better fits Alzheimer’s, making vascular dementia incorrect.

Choice D reason: Word-finding difficulties, as exhibited, are a hallmark of Alzheimer’s, reflecting language cortex involvement. This progressive aphasia, common in early stages, impairs communication, making it a correct clinical manifestation for this patient.

Choice E reason: Disorientation to time and place, though not explicitly stated, is a hallmark of Alzheimer’s, often emerging as memory declines. Given the patient’s MMSE score and symptoms, this is likely, making it a correct manifestation.