A nurse is planning care for a client who is experiencing thyroid storm triggered by a systemic infection. Which of the following interventions should the nurse plan to take?
Request a prescription for levothyroxine IV.
Administer supplemental oxygen to the client.
Cover the client with warm blankets.
Implement measures to increase the client's pulse rate.
The Correct Answer is B
A) "Limit sodium intake to 3,500 milligrams per day.":
Limiting sodium intake is crucial for managing heart failure to prevent fluid retention and exacerbation of symptoms. However, the recommended limit is typically much lower, around 1,500 to 2,000 milligrams per day, not 3,500 milligrams.
B) "Take ibuprofen for discomfort.":
Ibuprofen and other NSAIDs are not recommended for clients with heart failure as they can cause fluid retention, worsen heart failure symptoms, and increase the risk of kidney problems. Alternatives such as acetaminophen are generally safer for pain relief.
C) "Increase the distance you walk by 100 feet daily, even if you feel fatigued.":
While regular exercise is important, clients with heart failure should not push through fatigue, as overexertion can lead to worsening symptoms. Exercise recommendations should be tailored to the individual's tolerance and should be adjusted based on their energy levels.
D) "Include no more than 2,000 milliliters of fluid intake in 24 hours.":
Restricting fluid intake to 2,000 milliliters per day helps prevent fluid overload, which is critical for managing heart failure. Monitoring and limiting fluid intake can help control symptoms such as edema and shortness of breath.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "Clean the canister and cap of the inhaler every 2 weeks": While it's important to keep the inhaler clean, it should be cleaned more frequently than every 2 weeks. Typically, cleaning is recommended at least once a week to prevent medication buildup and ensure proper functioning.
B) "Wait 1 minute between puffs of the inhaler": Waiting 1 minute between puffs allows the medication from the first puff to take effect and opens the airways, making the second puff more effective. This practice helps maximize the medication's absorption and effectiveness.
C) "Tilt your head forward and inhale rapidly while depressing the canister": The correct technique involves tilting the head slightly back, not forward, to open the airways better. Additionally, the client should inhale slowly and deeply, rather than rapidly, to ensure the medication is properly delivered to the lungs.
D) "Place your middle finger at the mouthpiece and your thumb at the top of the inhaler": This description of finger placement is incorrect. The correct technique is to place the thumb at the base of the inhaler and the index and middle fingers on the top of the canister to allow for proper grip and activation of the inhaler.
Correct Answer is B
Explanation
A) HDL 65 mg/dL: High-density lipoprotein (HDL) levels of 65 mg/dL are considered protective against heart disease. Higher HDL levels are generally associated with a lower risk of cardiovascular disease, so this result is not a concern.
B) LDL 120 mg/dL: Low-density lipoprotein (LDL) levels of 120 mg/dL are elevated for individuals at increased risk of cardiovascular disease, especially with a family history of hyperlipidemia and cardiac disease. An LDL level above 100 mg/dL is a risk factor for heart disease, making this result important to report to the provider for potential intervention.
C) Cholesterol 195 mg/dL: A total cholesterol level of 195 mg/dL is slightly above the recommended level of less than 200 mg/dL but may not be immediately alarming unless the client has other risk factors. However, this value alone is not as critical as LDL levels in assessing risk.
D) Triglycerides 175 mg/dL: Triglyceride levels of 175 mg/dL are slightly elevated, as normal levels are typically less than 150 mg/dL. While elevated triglycerides are a risk factor for cardiovascular disease, this level is less critical compared to elevated LDL levels in the context of the client’s family history.
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