A nurse is reinforcing teaching with a female adolescent who has dysmenorrhea. Which of the following instructions should the nurse include?

Choice A rationale:
Lethargy, or extreme fatigue and sluggishness, is a characteristic symptom of hypothyroidism. Hypothyroidism occurs due to an underactive thyroid gland, which leads to a decrease in metabolic activity and energy levels. Children with hypothyroidism often exhibit lethargy, weakness, and a lack of interest in activities. This is due to the reduced metabolic rate and overall slowing down of bodily functions.
Choice B rationale:
Diarrhea is not a common finding associated with hypothyroidism. In fact, hypothyroidism tends to slow down gastrointestinal motility, leading to constipation rather than diarrhea. Therefore, diarrhea is not expected as a symptom in a child with hypothyroidism.
Choice C rationale:
Tachycardia, an elevated heart rate, is not typically associated with hypothyroidism. Instead, hypothyroidism often leads to bradycardia (a slower-than-normal heart rate) due to the overall slowing of the body's metabolic processes.
Choice D rationale:
Hirsutism, which refers to excessive hair growth in areas where hair growth is typically seen in males, is not a common finding in hypothyroidism. Hirsutism is more commonly associated with hormonal imbalances such as polycystic ovary syndrome (PCOS) rather than hypothyroidism.

Choice A rationale:
Tinnitus is the perception of noise or ringing in the ears. It can be caused by various factors, including exposure to loud noises, ear infections, and certain medications. However, tinnitus is not a commonly reported adverse effect of albuterol, which is a bronchodilator used to treat conditions like asthma and other respiratory disorders.
Choice B rationale:
Constipation is not a commonly reported adverse effect of albuterol. Albuterol primarily acts on the smooth muscles of the airways to relax and dilate them, improving airflow. Constipation is more likely related to issues with the gastrointestinal system or certain medications, but it is not a direct consequence of albuterol use.
Choice C rationale:
Hypoglycemia, or low blood sugar, is not a known adverse effect of albuterol. Albuterol primarily affects the respiratory system and does not typically impact blood glucose levels. Hypoglycemia is more commonly associated with diabetes medications like insulin or certain oral hypoglycemic agents.
Choice D rationale:
Headache is a potential adverse effect of albuterol. While not everyone will experience a headache when taking albuterol, it can occur as a side effect in some individuals. Albuterol can stimulate the sympathetic nervous system, leading to effects such as increased heart rate and potential vasodilation, which could contribute to the development of a headache in some cases. It's important for the parents of a child taking albuterol to be aware of potential side effects and report them to the healthcare provider if they occur.