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A nurse is caring for a client in an outpatient clinic.

 

Exhibits

Complete the following sentence by using the lists of options.

The client is at risk for

due to

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Levothyroxine is best absorbed on an empty stomach, typically taken 30–60 minutes before breakfast, and separately from other medications, especially multivitamins (iron and calcium) and esomeprazole (a proton pump inhibitor). The client has been taking levothyroxine after breakfast with other medications, which can interfere with its absorption. This leads to the risk of decreased therapeutic effectiveness, even though the current TSH is within normal range and free T4 is at the high end of normal.

Multivitamins (often contain calcium or iron): Can bind to levothyroxine and reduce its absorption. Esomeprazole: Alters gastric pH, which can impair levothyroxine absorption. Food intake: Taking levothyroxine with food reduces its bioavailability.


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Related Questions

Correct Answer is B

Explanation

A. Weight loss is a symptom of hyperthyroidism and would not indicate the need for a lower dose of methimazole.

B. Bradycardia could be a sign of hypothyroidism, which would indicate the need for a lower dose of methimazole.

C. Diaphoresis is a symptom of hyperthyroidism and does not indicate the need for a dose reduction.

D. Exophthalmos (bulging eyes) is a common symptom of Graves' disease but does not directly suggest the need for a dose reduction of methimazole.

Correct Answer is A

Explanation

A. Acetaminophen is metabolized by the liver, and a history of alcohol use disorder increases the risk of hepatotoxicity. The nurse should notify the provider before administration.

B. A blood pressure of 92/60 mm Hg is low but not contraindicated for acetaminophen, which does not typically affect blood pressure.

C. Recurrent headaches may be a reason for acetaminophen use and are not a contraindication.

D. Hypothyroidism does not interact adversely with acetaminophen and does not require withholding the medication.

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