A nurse is reviewing the medical records of clients on a hospital floor. Which client would the nurse expect is most at risk for hyperthyroidism?

Choice A reason: Hypertension
Hypertension, or high blood pressure, is not typically an expected finding in hypovolemic shock. In fact, one would expect the opposite, hypotension, due to the decreased circulating blood volume. Hypertension might be present in the initial stages due to compensatory mechanisms, but as the condition progresses, blood pressure usually drops.

Choice B reason: Bradypnea
Bradypnea, or abnormally slow breathing, is not a common finding in hypovolemic shock. Instead, tachypnea, or rapid breathing, may be observed as the body attempts to compensate for reduced oxygen delivery to tissues.

Choice C reason: Oliguria
Oliguria, or low urine output, is an expected finding in hypovolemic shock. As the blood volume decreases, the kidneys receive less blood flow, leading to reduced urine production. This is a protective mechanism to conserve body fluids, but it also indicates the severity of fluid loss and the need for urgent intervention.

Choice D reason: Flushing of the skin
Flushing of the skin is not an expected finding in hypovolemic shock. Instead, the skin may appear pale, cool, and clammy due to vasoconstriction and reduced blood flow to the periphery as the body prioritizes blood flow to vital organs.

Choice A reason:
Squamous cell carcinoma typically presents as a rough, scaly, red patch, open sore, or raised growth with a central depression, often on sun-exposed areas of the body. While it can appear as a lesion that varies in color, it is not commonly associated with a nevus that has increased in size.

Choice B reason:
Malignant melanoma is associated with changes in preexisting nevi, such as an increase in size and variations in color. It often appears as a mole that changes in color, size, or feel and may have irregular edges. The description of the lesion provided by the client is characteristic of malignant melanoma, making this the correct diagnosis.

Choice C reason:
Kaposi's sarcoma is a cancer that forms in the lining of blood and lymph vessels and typically appears as patches of abnormal tissue on the skin or mucous membranes. These lesions are usually red or purple and look similar to bruises¹. They are not typically described as nevi that increase in size or lesions that vary in color.

Choice D reason:
Basal cell carcinoma often appears as a slightly transparent bump on the skin, though it can take other forms. It usually presents as a pearly white or pink bump on white skin, or a brown or black bump on darker skin, and is most often found on sun-exposed areas. It is not typically associated with a nevus that has increased in size or an irregularly shaped lesion that varies in color.