A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse that the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.)

Choice A reason : A sore throat is a common side effect of radiation therapy to the neck area, particularly for cancer of the larynx. The radiation can cause inflammation and irritation of the throat and laryngeal tissues, leading to pain and discomfort when swallowing¹⁵. This side effect can be managed with pain relief medications and dietary adjustments to include softer foods and liquids.

Choice B reason : Dry mouth, or xerostomia, occurs when radiation damages the salivary glands, reducing saliva production. This can lead to difficulties in speaking, tasting, chewing, and swallowing, as well as an increased risk of dental problems¹³. Patients undergoing radiation therapy are often advised to stay hydrated and may be prescribed saliva substitutes or stimulants.

Choice C reason : Radiation to the neck might damage the thyroid gland, leading to hypothyroidism. Symptoms of thyroid problems due to radiation can include fatigue, weight gain, feeling cold, and having dry skin or hair³. Regular monitoring of thyroid function is recommended for patients who have received radiation therapy in the neck area.

Choice D reason : Lymphedema is swelling that can occur when radiation therapy affects the lymph nodes and vessels, impeding the flow of lymph fluid. In the context of neck radiation, this can lead to swelling in the neck and face³. Management includes physical therapy, compression garments, and careful skin care to prevent infection.

Choice A reason : Spironolactone is a potassium-sparing diuretic, which means it helps the body get rid of excess water without causing potassium loss. Therefore, a decreased potassium level would not be expected.

Choice B reason : Spironolactone can lead to hyperkalemia (increased potassium levels) and hyponatremia (decreased sodium levels) because it causes the kidneys to excrete sodium while retaining potassium.

Choice C reason : A decreased phosphate level is not a typical finding associated with spironolactone use. Phosphate levels are more commonly affected by renal function and parathyroid hormone levels.

Choice D reason : A decreased chloride level is not specifically associated with spironolactone. While electrolyte imbalances can occur, spironolactone primarily affects potassium and sodium balance.