The nurse is caring for a client with a new diagnosis of hyperthyroidism. Which intervention should the nurse prioritize?

Choice A reason: Huff coughing clears airway secretions but is less urgent than assessing oxygenation in acute dyspnea. COPD exacerbations reduce oxygen saturation, risking hypoxia. Pulse oximetry confirms the severity, guiding interventions, as coughing techniques are secondary to ensuring adequate oxygenation.

Choice B reason: Humidification prevents airway drying during oxygen therapy but does not address immediate dyspnea or hypoxia. Pulse oximetry is prioritized to assess oxygenation status in COPD exacerbation, as low oxygen levels require urgent intervention, making humidification a secondary consideration.

Choice C reason: Nebulizer treatments, like albuterol, relieve bronchospasm but require confirmation of hypoxia severity. Pulse oximetry assesses oxygen saturation, guiding whether nebulization or oxygen is needed. In acute COPD exacerbation, oxygenation status is critical to prioritize before administering treatments.

Choice D reason: Pulse oximetry measures oxygen saturation, critical in COPD exacerbation with dyspnea and tachypnea. Low saturation indicates hypoxia, guiding oxygen therapy or bronchodilator use. This objective data is the next priority after positioning, as it directs immediate interventions to prevent respiratory failure.

Choice A reason: Hyperthyroidism increases metabolic rate, causing tachycardia and potential arrhythmias due to elevated thyroid hormone levels stimulating cardiac beta-receptors. Monitoring heart rate and rhythm is critical to detect cardiovascular complications, guiding urgent treatment to prevent heart failure or atrial fibrillation.

Choice B reason: High-calorie snacks address weight loss in hyperthyroidism but are secondary to cardiovascular risks. Tachycardia and arrhythmias pose immediate threats, making heart rate monitoring the priority, as uncontrolled hyperthyroidism can lead to life-threatening cardiac events before nutritional needs are addressed.

Choice C reason: Supplemental oxygen is not routinely needed in hyperthyroidism unless respiratory distress occurs, which is rare. Elevated heart rate and arrhythmias are more immediate concerns, as hyperthyroidism’s cardiac effects are primary, making heart monitoring critical to prevent acute cardiovascular complications.

Choice D reason: Restricting fluid intake is inappropriate, as hyperthyroidism increases metabolism, risking dehydration. Heart rate monitoring is prioritized, as tachycardia and arrhythmias are direct, life-threatening effects of excess thyroid hormone, requiring immediate assessment to guide antithyroid therapy and prevent cardiac crises.