You are working evenings in the emergency room and are ready to end your shift. As you are about to leave, a client enters in a thyrotoxic crisis
a. What is a thyrotoxic crisis or thyroid storm and how do you treat it?
b. What are the symptoms the client is experiencing?
c. What labs will you expect to be drawn and why?
d. Name some of the causes that may have brought this crisis on.
Students' answers should include the following:
a. It is an abrupt life-threatening episode of hyperthyroidism.
Stress, trauma, diabetic ketoacidosis, infection, and pregnancy may bring the crisis on.
Aggressive treatment needs to be immediate for thyroid storm; cardiovascular system is affected; episode may be fatal
b. Client will present with elevated temperature as high as 106° F, rapid pulse, dysrhythmias of the heart, chest pain, nausea, vomiting, restlessness, and changes in consciousness.
c. Labs show elevated T3, T4, and TSH in the thyroid panel; thyroid panel gives the levels of the T3 and T4, which are secreted.
d. Oversecretion of T3 and T4 leads to epinephrine release, which increases metabolism; this causes the adrenal glands to produce excess corticosteroids.
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A reduction in the number of circulating RBCs or hemoglobin, which leads to inadequate oxygenation of tissues, is known as:
a. polycythemia. b. anemia. c. iron deficiency. d. an increase in hemoglobin.
With which of the following clients should the nurse remain alert to the possible development of high-output heart failure?
A. 40-year-old woman taking oral contraceptives B. 40-year-old man who broke an ankle while training for a marathon C. 68-year-old man with dehydration 5 years after having a myocardial infarction D. 27-year-old woman taking excessive amounts of thyroid hormone to promote weight loss
HP 2010 is a guidepost for nurses and interdisciplinary teams in community and public health. What actions would you take to meet the primary goals for HP 2010 in a high-school setting as a resource for the school nurse? (Select all that apply)
A) Establish a tobacco cessation program for students and faculty. B) Create a hearing and speech evaluation program. C) Establish a committee to create a self-sustaining sports and physical activity program. D) Create a program to educate staff and students regarding the impact of substance abuse on the student's body and prevention tactics. E) Establish an English as a second language program for students.
Which assessment should the nurse conduct for the client receiving beclomethasone (Beconase) nasal spray?
A. Assess the client's mouth for any sign of fungal infection. B. Assess the client's blood glucose prior to administration of nasal spray. C. Assess if the client has blown his nose prior to administration of nasal spray. D. Assess if the client has had a change in taste. E. Assess the client for any hoarseness or change in voice.