A nurse is assessing a client who is experiencing profuse vomiting.

Upon admission, the client's vital signs were within the expected reference range, but now the client's blood pressure is 86/58 mm Hg, his pulse is 114/min and weak, and his respiratory rate is 27/min.

The client appears restless and anxious and states that he thinks he is dying.

Which of the following actions should the nurse take first?

Choice A rationale

A corn tortilla with black beans is an excellent recommendation for a child with celiac disease. Corn is a naturally gluten-free grain, making corn tortillas a safe choice. Black beans are also gluten-free and provide essential protein, fiber, and iron, which are often deficient in a gluten-free diet. This meal provides a balanced and safe option for the child.

Choice B rationale

Low sodium vegetable soup with barley is an inappropriate recommendation because barley is a grain that contains gluten. Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Barley, along with wheat and rye, must be completely avoided to prevent an immune response and associated symptoms and intestinal damage.

Choice C rationale

Whole wheat pasta with shrimp is contraindicated for a child with celiac disease. Whole wheat is a form of wheat, which is a major source of gluten. Consuming whole wheat pasta would trigger an autoimmune reaction, causing inflammation and damage to the small intestinal villi, leading to malabsorption and a range of gastrointestinal symptoms.

Choice D rationale

A bologna sandwich on rye bread is a harmful choice for a child with celiac disease. Rye bread is made from rye grain, which is a source of gluten and must be avoided. The consumption of rye bread, like other gluten-containing grains, will provoke an immune response that damages the lining of the small intestine in individuals with this condition. *.

Choice A rationale

Drowsiness is a symptom of hypothyroidism, not hyperthyroidism (thyrotoxicosis). Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. An overdose or excessive dose of this medication would lead to symptoms of hyperthyroidism, which is the opposite of drowsiness. Instead, clients would likely experience increased energy levels, anxiety, or insomnia.

Choice B rationale

Weight gain is a classic symptom of hypothyroidism, not thyrotoxicosis. When the body's metabolism slows down due to insufficient thyroid hormone, the client may gain weight. A client experiencing thyrotoxicosis from an excessive dose of levothyroxine would typically exhibit a hypermetabolic state, which often leads to unintended weight loss despite an increased appetite.

Choice C rationale

A fever is a sign of an accelerated metabolic rate, which is a key feature of thyrotoxicosis. When thyroid hormone levels become excessively high, the body's basal metabolic rate increases significantly, causing an increase in body temperature. This can manifest as a low-grade fever or even a significant fever in severe cases, requiring immediate medical attention.

Choice D rationale

Bradycardia, or a slow heart rate, is a symptom of hypothyroidism. The heart rate slows down as the body's overall metabolic processes decrease. Thyrotoxicosis is characterized by a rapid heart rate, known as tachycardia. This is due to the excessive stimulation of the cardiovascular system by high levels of thyroid hormone. A normal heart rate is typically between 60 and 100 beats per minute. .