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Pulse oximeter reading 96%: A pulse oximeter reading of 96% is within the normal range (95-100%) and does not warrant immediate intervention. This indicates that the client's oxygen saturation is adequate.

Serum blood glucose level of 74 mg/dL: A serum blood glucose level of 74 mg/dL is within the normal range (70-100 mg/dL) for a fasting blood glucose level. This does not indicate an urgent issue, and no immediate intervention is needed for this value.

The client is lethargic and sleeps all the time: Lethargy and excessive sleep can be symptoms of myxedema coma, as it is a severe form of hypothyroidism. However, this is a common manifestation of the condition and does not require immediate intervention

To use the food pyramid for meal planning: The food pyramid may not be the most relevant tool in nutrition education. Often used are more detailed, individualized approaches like carb counting or plate method. This goal doesn’t address the client’s knowledge deficit.

To maintain current weight: While maintaining a healthy weight is important, this goal does not fully address the knowledge deficit about the client’s medical regimen, diet, and self-care management. It is more of an outcome rather than an educational goal.

To maintain vital signs within normal limits: Maintaining normal vital signs is important for overall health, but this goal does not directly relate to the client's understanding of how to manage their diabetes.

Decreased free thyroxine index: In Graves' disease, there is an overproduction of thyroid hormones, including thyroxine (T4), leading to an increase in the free thyroxine index, not a decrease. Elevated T4 levels are typical in hyperthyroidism associated with Graves' disease.

Decreased triiodothyronine (T3): Graves' disease usually results in increased levels of T3 and T4 due to the overactive thyroid. A decrease in T3 would be inconsistent with the hyperthyroid state seen in this disorder.

Decreased thyrotropin receptor antibodies: In Graves' disease, there is an increase in thyrotropin receptor antibodies, which stimulate the thyroid to produce excess thyroid hormones. These antibodies are often elevated, not decreased.

The nurse will monitor the client's blood glucose levels four (4) times a day: This is important, but it is an intervention rather than a goal. A goal should be measurable and focused on the client's outcome, such as maintaining specific glucose levels.

The client will demonstrate appropriate insulin injection techniques: This is a good educational goal, but it does not directly address the immediate concern. The problem states noncompliance, implying the client knows how to inject but isn't doing it consistently.

The client will maintain normal kidney function with 30-ml/hr urine output: While monitoring kidney function is important in diabetes, this goal does not address the immediate risk of hyperglycemia. Urine output is not the primary indicator of hyperglycemia.

Use sliding scale insulin to manage hypoglycemia: Sliding scale insulin is used to manage hyperglycemia, not hypoglycemia. Sick day management focuses on maintaining stable blood glucose levels, not using sliding scale insulin for hypoglycemia.

Increase intake of carbohydrates for the duration of the illness: It is not necessary to increase carbohydrate intake unless the client is unable to eat enough food. It’s more important to maintain hydration and monitor blood glucose levels, adjusting insulin doses as needed.

Report blood glucose lower than 100 mg/dL to the health care provider: Blood glucose levels below 100 mg/dL are generally considered within normal range. During illness, clients may experience higher blood glucose levels, which are more concerning.

Hyperglycemia occurring on "sick days": Glucagon is not used to treat hyperglycemia. During "sick days," clients with diabetes may experience elevated blood glucose levels, but glucagon is not for managing hyperglycemia. Instead, insulin adjustments are made.

Diabetic ketoacidosis: Glucagon is not used to treat diabetic ketoacidosis (DKA). DKA is a severe complication of diabetes often caused by insulin deficiency, and it requires insulin therapy and fluid management to correct the underlying issues.

Hyperglycemia from insufficient insulin: Glucagon is not used for hyperglycemia due to insufficient insulin. The treatment for this condition is typically insulin therapy to lower blood glucose levels.

Hypotension and bradycardia: Hypotension and bradycardia are associated with hypothyroidism or myxedema coma, not thyroid storm. In thyroid storm, the body experiences an increased metabolic rate, leading to elevated heart rate and blood pressure.

Decreased respirations and hypoxia: Decreased respirations and hypoxia are indicative of respiratory failure or conditions like severe hypothyroidism or myxedema coma, rather than thyroid storm, which causes increased metabolic demand and elevated respiratory rate.

Obstipation and hypoactive bowel sounds: These symptoms are more associated with hypothyroidism or severe constipation, not thyroid storm. In thyroid storm, bowel movements are typically more frequent due to the increased metabolic state.

Trendelenburg: Trendelenburg position (head down, feet elevated) is typically used for shock or hypotension, but it is not appropriate for a patient recovering from thyroid surgery. It can increase pressure on the neck and exacerbate swelling.

Supine: Lying flat on the back (supine) is not recommended post-thyroidectomy as it can lead to neck swelling and compromise the airway. It is better to keep the patient in a more elevated position to reduce the risk of respiratory distress.

Prone: The prone position (lying on the stomach) is not appropriate after thyroid surgery, as it could place unnecessary pressure on the neck and surgical site, potentially hindering recovery and breathing.