A client who had a cerebrovascular accident is assessed by a speech therapist after choking and having difficulty swallowing. Which of the following would be appropriate for the nurse to recommend?

Choice A reason: Epigastric fullness may suggest variceal pressure, but combativeness isn’t typical early bleeding; it’s more neurological, not a direct blood loss sign.

Choice B reason: Yellow sclera and hypoalbuminemia reflect liver dysfunction, not acute bleeding; hypertension contradicts blood loss, which lowers pressure initially.

Choice C reason: Bradycardia and lethargy occur late in severe hypovolemia, not early; hypotension fits bleeding but isn’t paired with early compensatory signs here.

Choice D reason: Tachycardia compensates for early blood loss in varices, restlessness reflects hypoxia, and pallor shows reduced perfusion, all classic initial bleeding indicators.

Choice A reason: Radioactive iodine treats hyperthyroidism by destroying thyroid tissue, reducing hormone production. It’s contraindicated in hypothyroidism, where hormone replacement is needed instead.

Choice B reason: Sumatriptan, a serotonin agonist, treats migraines by constricting blood vessels. It has no role in hypothyroidism, which requires thyroid hormone supplementation.

Choice C reason: Levothyroxine replaces deficient thyroid hormone in hypothyroidism, normalizing metabolism by mimicking T4, addressing symptoms like fatigue and weight gain effectively.

Choice D reason: Levofloxacin, an antibiotic, fights bacterial infections but doesn’t address hypothyroidism’s hormonal deficiency, making it irrelevant to this condition’s treatment.