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A nurse in the emergency department is caring for female client.

Exhibits
After reviewing the assessment findings, which of the following findings require follow-up?
(Select All that Apply.)

Breath sounds

Total T4

Oxygen saturation

Blood pressure

Bowel pattern

Potassium level

Answer and Explanation

Correct Answer : B,D

A. Breath sounds: Clear breath sounds are a normal finding and do not require follow-up.

B. Total T4: The client's Total T4 is 20 mcg/dL, which is significantly above the normal range (5 to 12 mcg/dL). This confirms the diagnosis of hyperthyroidism and is the root cause of the client's hypermetabolic symptoms.

C. Oxygen saturation: A saturation of 97% is within the normal range.

D. Blood pressure: The blood pressure of 168/70 mm Hg indicates systolic hypertension with a widened pulse pressure, which is characteristic of hyperthyroidism due to increased cardiac output. This requires follow-up to prevent cardiovascular complications like heart failure or stroke.

E. Bowel pattern: While 2-3 bowel movements per day is a symptom of increased gastric motility associated with the disease, it is not an immediate life-threatening finding compared to the T4 level and severe hypertension.

F. Potassium level: A level of 3.6 mEq/L is within the normal reference range (3.5 to 5 mEq/L).

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Correct Answer is ["A","C","E"]

Explanation

A. Schedule rest periods:The client's metabolism is "running a marathon," leading to exhaustion. Frequent rest lowers the metabolic demand on the heart.

B. Allow 1 month following radioactive iodine therapy for manifestations to subside:It typically takes 6 to 8 weeksor longer for the full effects of RAI therapy to manifest. One month may be too soon to expect full symptom resolution.

C. Flush the toilet with the lid closed:This is a specific precaution for clients receiving radioactive iodine (RAI)therapy. Since the radiation is excreted in body fluids (urine/stool), flushing with the lid closed prevents the aerosolization of radioactive particles.

D. Drink black tea to reduce diarrhea:Tea contains caffeine, a stimulant. Stimulants increase heart rate and metabolism, which are already dangerously high in this client.

E. Keep a record of food intake and weight:Due to the rapid weight loss, the nurse must monitor nutritional status to ensure the client is consuming enough calories (often a high-calorie diet is needed) to maintain weight.

A. Weak pulses B. Murmur C. Hypotension D. Bradycardia E. Clubbing of the nail beds

Correct Answer is ["A","B","C"]

Explanation

A. Weak pulses: Aortic stenosis involves the narrowing of the aortic valve, which obstructs blood flow from the left ventricle into the aorta (systemic circulation). Because less blood is being ejected, the peripheral pulses will be weak or thready.

B. Murmur:As blood is forced through the narrowed, stiff valve, it creates turbulence. This turbulence produces a characteristic systolic ejection murmur.

C. Hypotension:Due to the obstruction of blood flow, cardiac output decreases. This drop in the volume of blood entering the arteries leads to low blood pressure (hypotension) and a narrowed pulse pressure.

D. Bradycardia:The heart actually has to work harder to pump blood against the resistance of the narrowed valve. Additionally, the body attempts to compensate for the decreased cardiac output by increasing the heart rate (tachycardia), not decreasing it.

E. Clubbing of the nail beds:Clubbing is typically associated with chronic hypoxia found in cyanotic heart defects (right-to-left shunts) or chronic pulmonary disease. Aortic stenosis is an acyanotic defect; oxygen saturation typically remains normal unless severe heart failure develops.

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A nurse in the emergency department is caring for female client. Exhibits After reviewing the assessment findings, which of the following findings require follow-up? (Select All that Apply.)

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A nurse in the emergency department is caring for female client.

Exhibits
After reviewing the assessment findings, which of the following findings require follow-up?
(Select All that Apply.)