Which body substance should the nurse observe to evaluate the effectiveness of pancreatic enzyme replacement for a patient with chronic pancreatitis?

Choice A rationale
If a client reports chills and back pain during a blood transfusion, and their blood pressure is 80/64 mm Hg, the nurse’s first action should be to stop the infusion of blood. These symptoms could indicate an acute intravascular hemolytic transfusion reaction, and the greatest risk to the client is injury from receiving additional blood.

Choice B rationale
Notifying the laboratory is an important step in managing a transfusion reaction, but it is not the first action that should be taken.
Choice C rationale
Obtaining a urine specimen could be part of the overall assessment of the client’s condition, but it is not the first action that should be taken when a client is experiencing a potential transfusion reaction.
Choice D rationale
Informing the provider is an important step when a client is experiencing a reaction to a blood transfusion, but it is not the first action that should be taken.

Choice A rationale
Providing a quiet, low-stimulus environment is one of the key interventions for a patient with hyperthyroidism who is at risk of a thyroid crisis. Hyperthyroidism is characterized by an overproduction of thyroid hormones, which can accelerate the body’s metabolism causing symptoms such as rapid heart rate, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. A thyroid crisis, also known as a thyroid storm, is a severe, life-threatening condition characterized by extreme symptoms of hyperthyroidism. A quiet, low-stimulus environment can help reduce anxiety and agitation, which can exacerbate symptoms and potentially trigger a thyroid crisis.
Choice B rationale
Keeping the patient NPO (nothing by mouth) is not typically necessary in the management of hyperthyroidism unless the patient is preparing for a procedure such as thyroid surgery. In

fact, because of the increased metabolic rate in hyperthyroidism, patients often have an increased appetite and may require additional caloric intake.
Choice C rationale
Administering aspirin for any sign of hyperthermia is not recommended in hyperthyroidism. Aspirin can actually increase the level of free thyroid hormones in the blood by displacing them from their binding proteins, potentially worsening the hyperthyroid state.
Choice D rationale
While it is important to observe patients with hyperthyroidism for signs of various complications, hypocalcemia is not typically associated with hyperthyroidism. Hypocalcemia, or low calcium levels in the blood, is more commonly associated with hypoparathyroidism or vitamin D deficiency.