Reference no: EM133808371

Case: A 32-year-old female client with a history of hyperthyroidism is brought to the emergency department by their spouse. Nurses' Notes 0900: Accompanied by spouse, client reports being short of breath and having palpitations. Placed in ER treatment room directly from triage. Alert and oriented x 4 appears restless, anxious, and fatigued. Has flushed skin that is hot to touch. Bilateral eye protrusion noted, client states this is not their baseline and that their eyes feel "very dry." Lung sounds clear to auscultation, no reported cough but has intermittent and worsening dyspnea. Normal S1 and S2 and 2-3+ bilateral pulse strength palpated. Hyperactive bowel sounds auscultated on all 4 quadrants. The client does not report any pain and also states that they have felt excessive hunger and thirst over the past week that is unrelieved by oral intake. Also reports unexpectedly lost approximately 4.0 kg (approximately 8 lbs.) of body weight over the past week. Vital Signs Time 0900 Temp 103.2 F ( 39.6 C) P 137 RR 28 B/P 152/98 Pulse oximeter 97% on RA Pain 0 Laboratory Report Lab Results Reference Range White Blood Cells (WBC) 13 x 103 cells/mm3 4.5 - 10.5 x 103 cells/mm3 Potassium (serum) 5.0 mEq/L 3.5 to 5 mEq/L Sodium (serum) 142 mEq/L 135 to 145 mEq/L Thyroid stimulating hormone (TSH) 0.27 mU/L 0.45 to 4.5 mU/L Serum triiodothyronine (T3) 400 ng/dL 80 to 200 ng/dL Serum thyroxine (T4) 270 nmol/L 57 to 148 nmol/L.

Question 1). What 4 client findings are most urgent? Dyspnea 2-3+ pulse grade Tachycardia Palpitations Hunger Thirst Fever Anxiety Hyperactive bowel sounds Bilateral eye protrusion Hire Experts Now!

Question 2) For each assessment the nurse has made, click to specify whether the finding is helpful or not helpful in determining if the client is experiencing a thyroid problem. Finding Helpful Not helpful Fever Bilateral eye protrusion Lung sounds Anxiety level Palpitations Dyspnea

Question 3) The nurse recognizes that the condition the client is most likely experiencing is _________________.

Question 4) The client receives a working diagnosis of (answer #3). Which of the following orders should the nurse anticipate? Select all that apply. Humidified oxygen via nasal cannula at 2 L/min 12-lead EKG Administration of oral acetaminophen Application of a cooling blanket Administration of oral acetylsalicylic acid Administration of oral methimazole Administration of levothyroxine

Question 5) Describe the mechanism of action of a medication that you may see this patient being discharged with. What educational aspects would you like to educate your patient on?