The nurse recognizes that which of the following clients present at th

The nurse recognizes that which of the following clients present at the annual July 4th marathon is at greatest risk for hyperthermia and the resulting heatstroke?

1. A 34-year-old running for the first time in the July 4th marathon who is sweating profusely
2. A 16-year-old volunteer, with type 1, insulin-dependent diabetes, who is checking runners in for the marathon at the starting gate
3. A 75-year-old who is prescribed medication for Crohn’s disease and who is sit-ting outdoors watching her granddaughter run the marathon
4. A 55-year-old diagnosed with bipolar disease and prescribed a phenothiazine (Serentil), who will be walking the marathon course

ANSWER

ANS: 2
Clients at risk include those who are very young or very old and those who have cardiovascular disease, hypothyroidism, diabetes, or alcoholism. Also at risk are those who take medications that decrease the body’s ability to lose heat (e.g., phenothiazines, anticholinergics, diuretics, am-phetamines, and beta-adrenergic receptor antagonists) and those who exercise or work strenu-ously (e.g., athletes, construction workers, and farmers). While all the options represent risk fac-tors, the degree of exercise, medical history, and age are greatest for the 16-year-old client with diabetes.