A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Increased Hct. Propylthiouracil (PTU) is an antithyroid medication that reduces excessive thyroid hormone production in Graves' disease. It does not directly affect hematocrit (Hct) levels. While anemia can occur in some clients with untreated hyperthyroidism, PTU itself is not expected to raise Hct.

B. Decreased WBC count. A serious adverse effect of PTU is agranulocytosis, which results in a dangerously low white blood cell (WBC) count, increasing the risk of infection. However, this is a potential complication rather than an expected therapeutic outcome. Clients on PTU require regular monitoring of WBC levels to detect early signs of agranulocytosis.

C. Decreased heart rate. Graves’ disease causes hyperthyroidism, which increases metabolism and leads to symptoms such as tachycardia. PTU works by inhibiting thyroid hormone synthesis, leading to a gradual reduction in heart rate as thyroid function normalizes. This is a desired outcome of treatment, helping to reduce cardiovascular strain associated with hyperthyroidism.

D. Increased blood pressure. Hyperthyroidism can cause elevated blood pressure due to increased cardiac output. As PTU lowers thyroid hormone levels, blood pressure is expected to decrease or stabilize rather than increase. An increase in blood pressure would be unexpected and may indicate another underlying issue requiring evaluation.

A. "Do not take more than 200 milligrams of this medication within 24 hours." This statement is correct for oral sumatriptan, which has a maximum recommended dose of 200 mg per 24 hours. Clients can take one 50 mg or 100 mg dose initially, and if the headache persists, a second dose can be taken after at least 2 hours, provided the total daily dose does not exceed 200 mg.

B. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists." A second dose of sumatriptan can be taken at least 2 hours after the first dose if the headache has not fully resolved. However, if the headache persists after the maximum daily dose (200 mg), the client should not take additional doses and should seek medical evaluation.

C. "You should discontinue this medication if pregnancy is planned or suspected." Sumatriptan is classified as Pregnancy Category C, meaning its effects on fetal development are not well studied. Clients who are pregnant or planning to conceive should consult their healthcare provider before using this medication.

D. "You might experience a rash on your skin while taking this medication." Skin rash is not a common side effect of sumatriptan. If a rash develops, it could indicate an allergic reaction, which should be reported to a provider. However, routine monitoring for rashes is not necessary when taking sumatriptan.

E. "You might experience a feeling of pressure in your chest after taking this medication." Chest tightness or pressure is a known side effect of sumatriptan due to its vasoconstrictive effects. This sensation is usually temporary and not dangerous, but if it becomes severe or persistent, the client should seek medical attention to rule out cardiovascular complications.

F. "This medication can cause you to feel tired." Fatigue, drowsiness, and dizziness are common side effects of sumatriptan. Clients should be cautious when driving or operating machinery until they know how the medication affects them.

G. "This medication should start to alleviate the headache within 1 hour." Sumatriptan typically begins to relieve migraine symptoms within 30 to 60 minutes when taken orally. If the headache does not improve after 2 hours, a second dose may be taken, but the total daily dose should not exceed 200 mg.