A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.

A. Radioactive iodine uptake test: This test is used to assess thyroid function and diagnose thyroid disorders, such as hyperthyroidism. It is not used to diagnose Cushing syndrome.
B. 24-hour cortisol urine study: This test measures cortisol levels in the urine over a 24-hour period and is commonly used to diagnose Cushing syndrome by evaluating elevated cortisol production.
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test evaluates adrenal function and is typically used to assess adrenal insufficiency rather than Cushing syndrome.
D. Edrophonium (Tensilon) test: This test is used to diagnose myasthenia gravis, not Cushing syndrome. It evaluates the effect of the medication on muscle strength.