A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Choice A reason: An old friend with eczema coming for a visit is unlikely to cause an exacerbation of the client's symptoms. Eczema is not contagious, so contact with another person who has eczema should not worsen the condition. This choice does not provide useful information about potential triggers for the eczema flare-up.

Choice B reason: Receiving an influenza immunization is generally safe for individuals with eczema and is unlikely to cause an exacerbation of symptoms. Vaccinations do not typically provoke eczema flare-ups. This choice does not offer relevant information regarding potential causes of the worsening eczema symptoms.

Choice C reason: The application of corticosteroid cream to eczema is a common treatment to reduce inflammation and alleviate symptoms. It is unlikely to cause an exacerbation of eczema; in fact, it should help improve the condition. This choice does not explain the recent worsening of the eczema.

Choice D reason: A recent visit from a grandson and his new dog is a plausible trigger for an eczema flare-up. Pets, particularly new ones, can introduce allergens such as pet dander and saliva, which can aggravate eczema. This choice provides the most relevant information for determining the potential cause of the exacerbation.

Choice A reason: Activity intolerance related to ischemia is a common concern for clients with AMI, but it is not the primary nursing problem when the client is receiving thrombolytic therapy. The focus should be on monitoring for complications related to the therapy itself.

Choice B reason: Risk for injury related to effects of thrombolytics is the priority nursing problem for a client receiving thrombolytic therapy. Thrombolytics can cause serious bleeding complications, including internal bleeding, hemorrhage at vascular access sites, gastrointestinal bleeding, or intracranial bleeding. The nurse must closely monitor the client for signs and symptoms of bleeding, such as sudden onset or worsening of headache, changes in level of consciousness, hematuria, melena, ecchymosis, or hematoma formation.

Choice C reason: Ineffective breathing pattern related to adverse drug effects can occur following thrombolytic therapy, but it is not the primary concern. The risk of bleeding complications takes precedence as the priority nursing problem for this client.

Choice D reason: Deficient knowledge related to a new medication regimen is important for client understanding and adherence, but it is not the priority nursing problem in the immediate post-thrombolytic therapy period. Ensuring the client's safety by monitoring for bleeding complications is the primary focus.