A nurse is caring for a client who is postoperative following a complete thyroidectomy. Which of the following findings is the priority for the nurse to report to the provider?

A While this statement is factual, it may come off as dismissive of the client’s concerns. The client may feel that their feelings and autonomy are not being respected. It's important to provide education but also to engage the client in a conversation about their concerns.

B. While this statement is intended to provide reassurance and encouragement, it may not be accurate for all clients or situations. It could also oversimplify the client's concerns and may not address the specific reasons for their reluctance to take the medication.

C. This response emphasizes the potential consequences of not adhering to the prescribed treatment plan. It highlights the importance of the medication in managing or treating the client's condition effectively. However, it may come across as threatening or coercive, which is not conducive to building a trusting and collaborative relationship with the client.

D. This is an appropriate response as it acknowledges the client’s autonomy and concern. It indicates that the nurse respects the client’s wishes and that the client will have the opportunity to discuss their concerns further with the provider. This fosters open communication and may lead to a better understanding of the necessity of the medication.

A. This is a serious complication in DKA, particularly in children, where the shift in osmolality during treatment can lead to fluid shifts into the brain. It can present with neurological deterioration, headache, altered mental status, and even coma.
B. Septic shock
While infection can precipitate DKA, septic shock itself is not a direct complication of DKA. However, DKA can predispose patients to infections due to impaired immune function, dehydration, and hyperglycemia.
C. Cardiac arrhythmias
Electrolyte imbalances, particularly hypokalemia or hyperkalemia (depending on treatment phase), can predispose individuals with DKA to cardiac arrhythmias such as ventricular arrhythmias (e.g., ventricular tachycardia) or atrial fibrillation.
D. Renal failure
Acute kidney injury (AKI) can occur due to dehydration, electrolyte imbalances, and the direct effects of acidosis. However, with prompt and appropriate treatment, renal function typically recovers.
E. Hypotension
Dehydration and volume depletion are common in DKA due to osmotic diuresis and fluid loss. This can lead to hypovolemic shock and hypotension if not adequately managed with fluid resuscitation.
F Respiratory alkalosis
DKA is associated with metabolic acidosis, not respiratory alkalosis. The body compensates for acidosis by increasing respiratory rate (Kussmaul respirations) to blow off CO2 and normalize pH, but this does not lead to respiratory alkalosis.