A nurse is collecting data for a client’s health history as well as physical examination.
Which of the following information should the nurse identify as a risk factor for type 2 diabetes mellitus?

This is because the client has hypothyroidism, which means their thyroid gland does not produce enough thyroid hormone. Levothyroxine is a synthetic form of thyroid hormone that can replace the missing hormone and normalize the TSH level. The client’s TSH level is 8.9 mIU/L, which is above the normal range of 0.4 to 4.0 mIU/L. This indicates that the client’s current dosage of levothyroxine is insufficient and needs to be increased.

Choice A is wrong because thyroid ablation therapy is a treatment for hyperthyroidism, not hypothyroidism.

Thyroid ablation therapy involves destroying part or all of the thyroid gland with radioactive iodine or surgery, which reduces the production of thyroid hormone.

This would worsen the client’s condition and symptoms.

Choice C is wrong because lovastatin is a statin drug that lowers cholesterol levels. Hypothyroidism can cause high cholesterol levels, but this is usually corrected by levothyroxine therapy. Replacing lovastatin with cholestyramine, a bile acid sequestrant that also lowers cholesterol levels, would not address the underlying cause of hypothyroidism and would not improve the client’s TSH level.

Choice D is wrong because restricting the intake of iodized salt would not help the client with hypothyroidism. Iodine is an essential element for the synthesis of thyroid hormone, but most people in developed countries get enough iodine from their diet.

Hypothyroidism is usually caused by autoimmune disease, not iodine deficiency.

Offer the client fluids high in fiber and protein every hour. This is because clients who have bipolar disorder and are experiencing mania are at risk of dehydration, malnutrition, and weight loss due to increased activity, poor intake, and impaired judgment. Fluids high in fiber and protein can help prevent constipation and promote satiety.

Choice B is wrong because monitoring the client’s vital signs twice per day is not enough for a client who has mania. The nurse should monitor the client’s vital signs more frequently, at least every 4 hours, to assess for signs of dehydration, infection, or cardiac complications.

Choice C is wrong because encouraging the client to participate in group therapy activities each day can increase the client’s stimulation and agitation. The nurse should provide a calming environment with fewer stimuli and solitary activities for a client who has mania.

Choice D is wrong because weighing the client three times per week is not sufficient for a client who has mania. The nurse should weigh the client daily to monitor for weight loss and fluid imbalance.