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:

Asking questions about the information on her postoperative care pamphlet is a positive behavior indicating that the client is proactive in understanding her care and recovery process. It shows engagement and a desire to comply with medical advice, which is beneficial for recovery.

Choice B reason:

Refusing to look at the dressing or surgical incision may indicate psychological distress and difficulty in accepting the physical changes following a mastectomy. This behavior can be a sign of avoidance and a potential struggle with body image and the emotional impact of breast loss. It's important for healthcare providers to recognize this as a call for psychological support and possible referral to counseling services.

Choice C reason:

Performing arm exercises once or twice a day is typically recommended as part of the postoperative care after a mastectomy to prevent stiffness and improve mobility. This behavior suggests that the client is following postoperative instructions and actively participating in her recovery.

Choice A reason:
Abdominal distention can be a sign of delayed return of peristalsis or ileus, especially when accompanied by other symptoms such as nausea, vomiting, or lack of bowel movement. It is not typically a sign that peristalsis is returning.

Choice B reason:
A request for a cup of tea and some toast may indicate that the client is feeling better and is hungry, which can be a good sign. However, it is not a definitive clinical indicator of the return of peristalsis. The desire to eat does not necessarily mean that the digestive system is ready to process food.

Choice C reason:
Hypoactive bowel sounds in two quadrants may indicate that peristalsis is present but weak. While this could be a sign that peristalsis is starting to return, it is not as strong an indicator as the passage of flatus or stool.

Choice D reason:
The passage of flatus is a clear sign that peristalsis is returning. It indicates that gas is moving through the intestines, which is a function of peristalsis. This is often one of the first signs that the gastrointestinal system is recovering after surgery.