Which of these nursing interventions would minimize a client's risk of developing lipodystrophies?

Choice A rationale: An elevated temperature in a patient with Grave's disease, a form of hyperthyroidism, can be an early sign of a life-threatening condition called thyroid storm or thyrotoxic crisis. This is a severe, acute exacerbation of hyperthyroidism characterized by extreme hypermetabolism. The body's inability to cope with this heightened metabolic state leads to fever, tachycardia, severe hypertension, and potential heart failure, requiring immediate medical intervention to stabilize the patient. Normal body temperature is around 36.5-37.5°C (97.7-99.5°F).
Choice B rationale: Elevated blood pressure is a common finding in hyperthyroidism due to increased cardiac output and peripheral vasodilation. While it is a significant finding that requires monitoring and management, it does not typically pose the immediate, life-threatening risk that a sudden and marked elevation in body temperature suggests, which is a hallmark of an impending thyroid storm. Normal blood pressure is <120/80 mmHg.
Choice C rationale: A change in respiratory rate, such as an increase, can be associated with the hypermetabolic state of hyperthyroidism. However, it is a less specific and often less immediate indicator of a thyrotoxic crisis than a fever. While respiratory distress can occur, especially in severe cases, the elevated temperature is a more direct and urgent sign of systemic decompensation. Normal respiratory rate is 12-20 breaths per minute.
Choice D rationale: Irregular heart rate and rhythm, particularly atrial fibrillation, are frequent complications of hyperthyroidism. The excess thyroid hormone sensitizes the heart to catecholamines, leading to arrhythmias. While this requires careful management to prevent complications like stroke, it is a chronic manifestation. A new or sudden onset of fever is a more acute and urgent indicator of a potentially fatal crisis. Normal heart rate is 60-100 bpm.

Choice A rationale: This statement is incorrect. While the abdomen is a preferred injection site due to its large subcutaneous fat layer and consistent absorption, the proximity to the pancreas is not the reason. The pancreas's location is irrelevant to where insulin is absorbed and distributed systemically. The statement shows a misunderstanding of anatomy and pharmacology.
Choice B rationale: This is a correct statement. Using different areas within the same site, such as the thigh, is a good practice for rotating injection spots. It helps prevent lipodystrophy (fat hypertrophy or atrophy) and ensures consistent insulin absorption. The thigh is an appropriate injection site.
Choice C rationale: This is a correct statement. Rotating injection sites within one area, such as the abdomen, minimizes the risk of tissue damage and the formation of scar tissue or lumps (lipohypertrophy). These reactions can alter insulin absorption, making blood glucose management unpredictable.
Choice D rationale: This is a correct statement. Insulin absorption rates vary between different injection sites. The abdomen generally has the fastest absorption, followed by the arm, thigh, and buttocks. This is due to differences in blood flow and subcutaneous tissue composition. Changing sites can thus change absorption rates.