Which instruction will the nurse plan to include in discharge teaching for a patient who was admitted with a sickle cell crisis?

Choice A reason: Low T4 levels do not indicate hyperthyroidism. In fact, low levels of T4 are typically associated with hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormones.
Choice B reason: High T4 levels are indicative of hyperthyroidism. In hyperthyroidism, the thyroid gland is overactive and produces excessive amounts of thyroid hormone (T4), leading to elevated T4 levels in the blood.
Choice C reason: Low TSH levels are also indicative of hyperthyroidism. The pituitary gland secretes TSH to regulate thyroid hormone production. When thyroid hormone levels are high, as in hyperthyroidism, the pituitary gland reduces TSH secretion, resulting in low TSH levels.
Choice D reason: High TSH levels are not associated with hyperthyroidism. Elevated TSH levels are more commonly seen in hypothyroidism, where the thyroid gland is underactive, and the pituitary gland compensates by increasing TSH production to stimulate the thyroid gland.

Choice A reason: Reassessing vital signs in 1 hour is not an immediate action and does not address the patient’s current symptoms of dizziness and unsteady gait, which indicate a potential problem that requires immediate attention. Waiting an hour to reassess may delay necessary interventions that could prevent harm.
Choice B reason: Assisting the patient into a sitting position and notifying the healthcare provider is the most appropriate action. The symptoms of dizziness and unsteady gait, along with a BP of 98/60 mmHg, suggest that the patient may be experiencing orthostatic hypotension or a side effect of Carbidopa-Levodopa. Elevating the patient's position can help prevent falls, and notifying the healthcare provider ensures that the situation is assessed and managed promptly. This action addresses the immediate safety of the patient and facilitates appropriate medical intervention.
Choice C reason: Administering the next dose of Carbidopa-Levodopa early is not recommended without specific orders from the healthcare provider. It could potentially lead to overmedication and worsen the patient’s symptoms or cause adverse effects. Medication administration should always follow the prescribed schedule unless otherwise directed by the healthcare provider.
Choice D reason: Educating the patient about increasing his exercise is important for overall health and mobility but is not an immediate intervention for the acute symptoms of dizziness and unsteady gait. The patient’s current condition requires prompt assessment and intervention rather than education on exercise, which can be addressed later once the immediate issue is managed.