After receiving change-of-shift report about the following four patients, which patient should the nurse assess first? A) A 22-year-old admitted with SIADH who has a serum sodium level of 130 mEq/L B) A 31-year-old who has iatrogenic Cushing syndrome with a capillary blood glucose level of 204 mg/dL C) A 53-year-old who has Addison disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef) D) A 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and has an elevated temperature of 103.2^°F

Question

Quizplus · Accepted Answer

Manipulation of a hyperactive thyroid gland during thyroidectomy can cause thyroid storm. It is manifested by very high fever, extreme cardiovascular effects (tachycardia, HF, angina), and severe CNS effects (agitation, restlessness, and delirium). Answer choice A refers to normal sodium levels. Answer choice B refers to high blood glucose level but not critical level. Answer choice C refers to lower priority. It is always preferred to give medications in a timely manner; however, thyroid storm signs and symptoms are the priority for this group of patients.

After Receiving Change-Of-Shift Report About the Following Four Patients, Which