The nurse has reviewed the Graphic Record and Diagnostic Results at 1030.

The nurse is collaborating with another nurse about the client's plan of care. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

• seizures: If a thyroid storm occurs, the client can experience seizures due to the extreme metabolic disturbances and nervous system overstimulation it causes. Seizures would be a serious complication indicating worsening neurological function. Therefore, the client’s risk for seizures is directly related to the risk of developing a thyroid storm after surgery.
• paralytic ileus: Paralytic ileus involves bowel inactivity post-surgery, but the client had normoactive bowel sounds before surgery and no current documentation of absent or significantly reduced bowel activity. Therefore, this is not the most immediate risk based on current findings.
• pneumonia: The client is receiving oxygen therapy and has a slightly increased respiratory rate after surgery, but no signs of labored breathing, abnormal lung sounds, or infection are reported. Although inactivity can contribute to pneumonia risk postoperatively, there are no current findings indicating that pneumonia is developing right now.
• thyroid storm: The client had a thyroidectomy after presenting with signs of severe hyperthyroidism (weight loss, heat intolerance, anxiety, exophthalmos, goiter) and elevated T3 and T4 levels. Thyroid storm is a critical risk after thyroidectomy due to sudden hormone release, and it can cause life-threatening complications such as high fever, hypertension, tachycardia, and altered mental status.
• bowel sounds: The bowel sounds were normal before surgery, and there is no mention of significant gastrointestinal changes postoperatively. Bowel sounds alone are not the critical factor leading to the client’s highest current risk.
• inactivity: The client is currently lethargic after surgery and under the effects of anesthesia, which reduces movement and activity. Inactivity can cause decreased lung expansion and increase the risk of pulmonary complications like pneumonia. Although this is a concern, inactivity is not the client's most critical immediate risk compared to thyroid storm.

A. "The client in room 204 received some pain medicine earlier today": This statement is vague and nonspecific, lacking essential information such as the type of pain medication, dose, timing, and client response. Change-of-shift reports require clear, detailed, and actionable information to ensure continuity of care.

B. "The client in room 205 has had several visitors today": Information about visitors is generally not relevant to clinical care unless it impacts the client's condition. Reporting should focus on clinical updates, treatments, medications, or changes in the client’s status that require attention from the incoming nurse.

C. "The client in room 204 has a new prescription for gentamicin": This statement provides important clinical information regarding a change in the medication regimen. It alerts the next nurse to monitor for potential side effects, such as nephrotoxicity or ototoxicity, associated with gentamicin use.

D. "The client in room 203 will undergo surgery at 0900 tomorrow": Communicating scheduled surgeries is critical for planning preoperative care, ensuring that preoperative checklists are completed, and managing fasting requirements. It allows the next shift to prepare the client properly and coordinate care.

E. "The client in room 205 is scheduled for a dressing change at 1800": Including scheduled treatments like dressing changes ensures that important interventions are completed on time. It also helps the incoming nurse prioritize tasks and manage the shift effectively to meet the client’s care needs.