A nurse assesses a patient with hypothyroidism who is admitted with acute appendicitis. The nurse notes that the patient's level of consciousness has decreased. What action does the nurse perform?
Restricts oral intake.
Monitor blood pressure every 4 hours.
Administer SQ insulin as prescribed.
Maintain a patent airway.
The Correct Answer is D
A decrease in the level of consciousness is a serious sign and could be an indication of worsening conditions. It is essential for the nurse to ensure that the patient's airway is open and clear, as a compromised airway can lead to hypoxia and a further decrease in consciousness. Therefore, maintaining a patent airway should be the nurse's priority action in this situation.
While monitoring blood pressure and restricting oral intake may be important interventions in certain situations, they are not the priority actions in this scenario. Administering SQ insulin may not be necessary for a patient with hypothyroidism and acute appendicitis.


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Related Questions
Correct Answer is D
Explanation
A decrease in the level of consciousness is a serious sign and could be an indication of worsening conditions. It is essential for the nurse to ensure that the patient's airway is open and clear, as a compromised airway can lead to hypoxia and a further decrease in consciousness. Therefore, maintaining a patent airway should be the nurse's priority action in this situation.
While monitoring blood pressure and restricting oral intake may be important interventions in certain situations, they are not the priority actions in this scenario. Administering SQ insulin may not be necessary for a patient with hypothyroidism and acute appendicitis.


Correct Answer is B
Explanation
Since the patient's blood glucose level is less than 70 mg/dL and they are symptomatic, the first step is to administer 1 mg Glucagon IM. This will help increase the patient's blood glucose level quickly.
After administering Glucagon, the nurse should then call the MD to report the low blood glucose level and discuss any necessary adjustments to the patient's insulin regimen. It is important to note that in this situation, administering Humalog insulin would further lower the patient's blood glucose level and could worsen their symptoms. Encouraging the patient to eat their meal is also important, but it should be done after the administration of Glucagon to help maintain their blood glucose level.
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