Goiter

The nurse would assess for hyperkalemia by observing for which EKG change:

Paramedics bring a 66-year-old woman to the ED. Her blood pressure is 104/58 mmHg, pulse rate 44 beats/minute, respiratory rate 14 breaths/minute, and temperature 92.4o F (33.6oC). No medical history is available, except for the patient’s statement of not feeling well for the past month. Physical examination reveals a lethargic, thin woman with dry skin and periorbital and facial edema. Bilateral pulmonary congestion is noted. EKG monitoring shows sinus bradycardia. The physician diagnoses impending myxedema coma. The patient remains hypothermic, with a temperature of 95o F (35oC). The nurse would anticipate the treatment for this patient to include all of the following except:

A 47-year-old man is brought to the ED. His family reports that he had become confused over the past 72 hours and suffered a seizure while on the way to the hospital. Upon arrival, the patient is minimally responsive. His respiratory rate is 32 breaths/minute, pulse rate 110 beats/minute, and blood pressure 120/90 mmHg. Immediate laboratory work reveals an abnormal sodium level of 117 mEq/L. The patient’s chest X-ray reveals a mass in the right mid-lung field. The nurse suspects that the underlying factor responsible for this patient’s change in mental status is related to:

Which fluid replacement method would the nurse expect to administer to a patient with adrenal crisis?

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of:

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of:

Which patient would not be considered at risk for developing SIADH?

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of:

A friend brings a 25-year-old man to the ED. The patient had been complaining of blurred vision, headache, slurred speech, and weakness. He is now comatose. Earlier in the morning, he had been playing tennis. Immediate laboratory studies indicate a serum glucose level of 34 mg/dL. The nurse suspects that this patient’s symptoms resulted from:

A 55-year-old woman is admitted to the ED with a temperature of 105o F (40.5oC), blood pressure 180/110 mmHg, pulse rate 120 beats/minute, and respiratory rate 36 breaths/minute. She shows signs of dehydration and states that she has been experiencing muscle weakness and bone pain for the past week. She has a history of Grave’s disease. The physician diagnoses thyroid crisis. The patient begins to complain of bone pain and thirst. The nurse notes a decreased level of consciousness and hypotonicity of muscles. Which laboratory findings should be monitored in this situation?