Which of the following assessments would be most indicative of thyroid storm (thyrotoxicosis) in a client with poorly managed hyperthyroidism?

A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.

A. Administer an oral potassium supplement is incorrect. Potassium imbalances can cause muscle weakness and cramps, but the client’s symptoms are more likely related to hypocalcemia rather than hypokalemia. Administering potassium without verifying the actual cause of the symptoms could be inappropriate.

B. Request prescription for a relaxant is incorrect. While muscle spasms can be painful, the first priority is to address the underlying cause of the spasms, which in this case is likely hypocalcemia. A muscle relaxant might not address the root cause and could delay appropriate treatment.

C. Check the pedal pulses is incorrect. While checking pedal pulses is important for assessing circulation, the client's symptoms of severe muscle spasms are more indicative of hypocalcemia rather than a circulation issue. The nurse's priority should be to address the electrolyte imbalance.