A nurse is reinforcing teaching with a client who has hypothyroidism and a new prescription for levothyroxine.

The nurse should instruct the client to notify the provider of which of the following manifestations of thyrotoxicosis?

A.Coiling the tubing on the bed above the collection bag is incorrect because it can cause urine to flow back into the bladder, increasing the risk of infection and compromising the effectiveness of the drainage system. The tubing should be kept below the level of the bladder to ensure proper drainage.

B.Instructing the client to hold the drainage bag at waist height when ambulating is incorrect because the drainage bag should always be kept below the level of the bladder to prevent urine from flowing back into the bladder, which could lead to a urinary tract infection (UTI).

C.Securing the tubing with adhesive tape to the lower abdomen is correct because it helps prevent accidental pulling or tugging on the catheter, which could cause discomfort or dislodgement. Properly securing the tubing also helps maintain a continuous flow of urine and reduces the risk of infection.

D.Collecting a sterile specimen from the urinary drainage bag is incorrect because urine in the drainage bag is not considered sterile. If a sterile specimen is needed, it should be obtained by cleaning the catheter's sampling port with an antiseptic solution and withdrawing urine directly from the port using a sterile syringe.

Explanation

A. Increased erythrocyte sedimentation rate

A. Increased erythrocyte sedimentation rate (ESR) is a non-specific marker of inflammation in the body. In the presence of an infection, the ESR tends to rise due to increased levels of acute-phase reactants, such as fibrinogen and globulins. However, it is important to note that an increased ESR alone does not diagnose a specific infection but rather indicates the presence of inflammation or infection.

Decreased platelets in (option B) should not be included because they are not typically associated with infection. Low platelet levels (thrombocytopenia) may occur due to various reasons, such as certain medications, immune disorders, or bone marrow problems, but they are not directly linked to infections.

Increased iron level in (option C) should not be included because it is not a typical finding in an active infection. In fact, during an infection, iron levels tend to decrease in response to the body's efforts to withhold iron from pathogens, as most microorganisms require iron for their growth and survival.

Decreased haemoglobin in (option D) should not be included because it is not directly indicative of an infection. A decrease in hemoglobin levels may be associated with conditions such as anaemia, blood loss, or certain chronic diseases, but it is not a specific marker for infection.