A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client?

Choice A reason: Administering levothyroxine at bedtime is not a correct statement, as it may interfere with sleep quality and hormone absorption. Levothyroxine is a synthetic thyroid hormone that replaces or supplements low levels of natural thyroid hormone in hypothyroidism. Levothyroxine should be taken in the morning, at least 30 minutes before breakfast, to avoid insomnia and ensure optimal absorption.

Choice B reason: Consuming foods that are high in iodine is not a correct statement, as it may affect thyroid function and hormone levels. Iodine is an essential element that is needed for thyroid hormone synthesis. However, too much or too little iodine can cause thyroid disorders, such as goiter or hyperthyroidism. Levothyroxine does not require additional iodine intake, and clients should follow a balanced diet.

Choice C reason: Avoiding the use of iron supplements is a correct statement, but it is not specific to levothyroxine. Iron supplements can interfere with many medications, including levothyroxine, by reducing their absorption and efficacy. Iron supplements should be taken at least 4 hours before or after levothyroxine or other medications.

Choice D reason: Taking medication on an empty stomach is a correct statement that indicates effective education. Levothyroxine should be taken on an empty stomach, preferably in the morning, to avoid food-drug interactions and enhance absorption. Food, especially those high in fiber or calcium, can decrease levothyroxine absorption and effectiveness.

Choice A reason: Telling the client to notify the nurse if the pain is not relieved is an important nursing action, but it is not the highest priority. The nurse should assess the client's pain level before and after administering the medication, and evaluate its effectiveness. If the pain is not relieved, the nurse should report it to the prescriber and consider other interventions.

Choice B reason: Advising the client that the medication should start to work in about 30 minutes is an informative nursing action, but it is not the highest priority. The nurse should educate the client about the expected onset, peak, and duration of action of the medication, and how to take it safely and effectively. However, this does not address any immediate risks or needs of the client.

Choice C reason: Administering a stool softener/laxative at the same time as the analgesic is a preventive nursing action, but it is not the highest priority. The nurse should anticipate and prevent potential side effects of the medication, such as constipation, which can be caused by codeine. However, this does not address any urgent or emergent issues of the client.

Choice D reason: Instructing the client to request assistance when ambulating to the bathroom is the highest priority nursing action, as it addresses a serious safety concern of the client. The nurse should protect the client from falls and injuries, which can be caused by codeine's sedative and drowsy effects. The nurse should also monitor the client's respiratory rate and level of consciousness, as codeine can cause respiratory depression and altered mental status.