A nurse is assisting with the care of a client.

Vital Signs.

1330: Temperature 36.8 °C (98.2 °F) Heart rate 88/min.

Respiratory rate 16/min.

Blood pressure 110/64 mm Hg. 1345: Oxygen saturation 96% on 3 L/min via simple face mask.

Temperature 37 °C (98.6 °F) Heart rate 112/min.

Respiratory rate 20/min.

Blood pressure 108/60 mm Hg. 1400: Oxygen saturation 94% on 3 L/min via simple face mask.

Temperature 38.3 °C (101 °F) Heart rate 152/min.

For each data collection finding, click to specify if the finding is consistent with malignant hyperthermia, latex allergy, or hypovolemic shock.

Each finding may support more than 1 disease process.

Choice B rationale:

Prothrombin time. Monitoring prothrombin time is not typically required for clients taking levothyroxine. Prothrombin time is a measure of blood clotting and is not directly affected by thyroid hormone replacement therapy.

Choice C rationale:

Blood urea nitrogen. Monitoring blood urea nitrogen is not specifically related to levothyroxine therapy. Blood urea nitrogen is a measure of kidney function and is not typically affected by thyroid hormone replacement.

Choice D rationale:

Serum potassium. Monitoring serum potassium levels is important for some medications, but it is not a primary concern when a client is taking levothyroxine. Levothyroxine is primarily used to replace or supplement thyroid hormones, and its main focus is on thyroid function.

Choice A rationale:

Triiodothyronine. Triiodothyronine (T3) is one of the thyroid hormones, and monitoring its levels is essential when a client is taking levothyroxine. Levothyroxine is a synthetic form of thyroxine (T4), which the body converts into triiodothyronine (T3) Monitoring T3 levels helps ensure that the client's thyroid hormone replacement therapy is effective and that they are not experiencing over- or under-dosage.

Choice A rationale:

"I should have my baby latch on to my nipple and areola during feeding." Rationale: This is the correct statement and indicates an understanding of breastfeeding. Proper latch involves the baby taking both the nipple and a portion of the areola into their mouth. This ensures effective milk transfer and prevents nipple pain and damage.

Choice B rationale:

"I should not wake my baby during the night to breastfeed." Rationale: While it is generally recommended to let a newborn sleep for longer stretches at night, it's essential to ensure the baby feeds frequently, especially in the early days. Waking the baby for feedings, at least every 2-3 hours, is important to establish a good milk supply and ensure the baby's nutritional needs are met.

Choice C rationale:

"My baby should breastfeed 5 to 10 minutes on each breast." Rationale: This statement is not entirely accurate. The duration of breastfeeding can vary from baby to baby. It's essential to allow the baby to feed as long as they want on the first breast, ensuring they get the hindmilk, which is rich in fat and essential for growth. The baby may switch to the other breast when they are ready.

Choice D rationale:

"I should keep my baby on a strict feeding schedule." Rationale: This statement is not correct. Breastfeeding is demand-driven, and it's important to feed the baby when they show hunger cues, which may not always align with a strict schedule. Feeding on demand helps ensure the baby receives enough nourishment and promotes milk supply.