A nurse is providing discharge instructions to a client who has rheumatoid arthritis and a prescription for oral betamethasone. Which of the following statements should the nurse make about how to take this medication?

Choice A reason: Exophthalmos

Exophthalmos, or bulging eyes, is not a typical symptom of hypothyroidism. Instead, it is commonly associated with hyperthyroidism, particularly Graves’ disease. In hypothyroidism, the thyroid gland is underactive, leading to a different set of symptoms.

Choice B reason: Photophobia

Photophobia, or sensitivity to light, is not a common symptom of hypothyroidism. While hypothyroidism can cause a variety of symptoms, photophobia is more often associated with conditions affecting the eyes or the nervous system.

Choice C reason: Lethargy

Lethargy, or extreme fatigue, is a common symptom of hypothyroidism. When the thyroid gland does not produce enough thyroid hormones, the body’s metabolism slows down, leading to feelings of tiredness and lack of energy. This is one of the hallmark symptoms of hypothyroidism and can significantly impact a person’s daily life.

Choice D reason: Weight Loss

Weight loss is not typically associated with hypothyroidism. In fact, weight gain is more common due to the slowed metabolism caused by an underactive thyroid. Individuals with hypothyroidism often experience difficulty losing weight and may gain weight even with a normal diet and exercise routine.

Choice A reason:

Using the palm of the hand, feel for lumps using a circular motion: This instruction is incorrect. The correct method for a breast self-exam involves using the pads of the three middle fingers, not the palm of the hand. The fingers should move in a circular motion to feel for lumps or abnormalities.

Choice B reason:

Expect some breast dimpling or discharge with age: This is misleading and potentially harmful advice. While some changes in the breast can occur with age, dimpling or discharge can also be signs of breast cancer and should be reported to a healthcare provider immediately.

Choice C reason:

Breasts can be examined in the shower with soapy hands: This is correct. Examining the breasts in the shower with soapy hands can make it easier to feel for lumps or changes. The soapy water helps the fingers glide smoothly over the skin, making it easier to detect any abnormalities.

Choice D reason:

For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation: This instruction is incorrect. The best time to perform a breast self-exam is a few days after the menstrual period ends, when the breasts are least likely to be swollen or tender.