A nurse is assisting with the care of a client.

Exhibits

The nurse is collecting data from the client.

Drag words from the choices below to fill in each blank in the following sentence.

The nurse should identify that

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and

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indicate manifestations of borderline personality disorder.

A. Prothrombin time. Levothyroxine does not directly affect coagulation parameters. However, it can enhance the effects of anticoagulants, potentially leading to an increased risk of bleeding, but prothrombin time is not routinely monitored for levothyroxine therapy.
B. Arterial blood gases. Levothyroxine does not typically alter arterial blood gas levels. While severe hypothyroidism can lead to respiratory complications, routine ABG monitoring is not required for clients taking this medication.
C. Blood urea nitrogen. BUN levels assess kidney function but are not directly influenced by levothyroxine. Although hypothyroidism can cause mild alterations in kidney function, BUN is not the primary test for monitoring levothyroxine therapy.
D. Thyroid stimulating hormone. TSH levels are regularly monitored to evaluate the effectiveness of levothyroxine therapy. Since levothyroxine replaces thyroid hormone, TSH levels should decrease as the thyroid hormone levels normalize. Adjustments in dosing are based on TSH results.

A. Apply water-soluble lubricant to the site. Lubricants are not necessary for gastrostomy tube site care. Instead, the nurse should keep the area clean and dry to prevent irritation and infection. Applying lubricant could increase moisture, potentially leading to skin breakdown or fungal infections.
B. Attach an extension tube to the site's opening prior to use. Extension tubes are only needed for certain types of gastrostomy devices, such as low-profile buttons, and should be attached only when feeding or administering medications. Continuous attachment is unnecessary and may increase the risk of dislodgment or contamination.
C. Tape the tube to the child's cheek. Taping a gastrostomy tube to the cheek is inappropriate, as it does not provide adequate stabilization and may cause discomfort. This technique is more commonly used for securing nasogastric tubes rather than gastrostomy tubes.
D. Secure the tubing to the child's abdomen. Properly securing the gastrostomy tube to the abdomen helps prevent accidental dislodgment, irritation, and skin breakdown. The tube should be secured with tape or a securement device while allowing slight movement to reduce tension on the insertion site.