The patient is a 49-year-old male who has been experiencing flu-like symptoms, including fever and chest congestion, for 4 days.

He came to the emergency department (ED) last night when his breathing difficulties increased. He has a history of smoking half a pack of cigarettes a day for 20 years.

He has no significant medical or surgical history.

Which two orders should the nurse prioritize?

Choice A rationale
Anticipating and monitoring for hypothermia is the most crucial nursing intervention to include in the care plan for a patient who is 12 hours post-thyroidectomy. The thyroid gland plays a significant role in regulating the body’s metabolism, including temperature regulation. After a thyroidectomy, the body may struggle to regulate temperature, leading to hypothermia. The nurse should monitor the patient’s temperature regularly and provide warming measures as needed.

Choice B rationale
Preparing to administer radioactive iodine treatments is not the most crucial intervention at this time. Radioactive iodine is typically used as a treatment for hyperthyroidism or thyroid cancer, not as an immediate post-operative intervention.

Choice C rationale
Resuming antithyroid drug therapy is not the most crucial intervention at this time. Antithyroid drugs are used to treat hyperthyroidism, and their use would need to be evaluated based on the reason for the thyroidectomy and the patient’s post-operative thyroid hormone levels.

Choice D rationale
Maintaining a semi-Fowler position can be beneficial for comfort and respiratory function post-operatively, but it is not the most crucial intervention. The nurse should assist the patient to a comfortable position and encourage regular deep breathing and coughing exercises to prevent respiratory complications.

Choice A rationale
Osteoarthritis is a type of arthritis that occurs when the cartilage that cushions the ends of your bones in your joints gradually deteriorates. Osteoarthritis symptoms often develop slowly and worsen over time. They can include: Pain in the joint during or after use, or after periods of inactivity, Tenderness in the joint when you apply light pressure to or near it, Stiffness in the joint, that may be most noticeable when you wake up in the morning or after a period of inactivity, Loss of flexibility in the joint, Grating sensation or sound when you use the joint. But in this case, the client’s symptoms do not align with those of osteoarthritis.

Choice B rationale
Rheumatoid Arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints, Joint stiffness that is usually worse in the mornings and after inactivity, Fatigue, fever and loss of appetite. The client’s symptoms align with those of Rheumatoid Arthritis.

Choice C rationale
Carpal Tunnel Syndrome is a condition that causes numbness, tingling and other symptoms in the hand and arm. Carpal tunnel syndrome is caused by a compressed nerve in the carpal tunnel, a narrow passageway on the palm side of your wrist. The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome. But in this case, the client’s symptoms do not align with those of Carpal Tunnel Syndrome.

Choice D rationale
Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable. But in this case, the client’s symptoms do not align with those of Gout.