A nurse is teaching about levothyroxine to a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client?
"Tremors, nervousness, and insomnia may indicate your dose is too high."
The medication decreases the overproduction of the thyroid hormone thyroxine."
Take this medication until your symptoms are gone and then discontinue."
"Symptoms improve immediately after starting the medication."
The Correct Answer is A
A. "Tremors, nervousness, and insomnia may indicate your dose is too high." — These are signs of hyperthyroidism and may indicate overdosage of levothyroxine, which should be reported to the healthcare provider.
B. "The medication decreases the overproduction of the thyroid hormone thyroxine." — Levothyroxine is used to replace low levels of thyroid hormone in hypothyroidism, not to reduce overproduction.
C. "Take this medication until your symptoms are gone and then discontinue." — Levothyroxine is usually a lifelong therapy for primary hypothyroidism, not a short-term treatment.
D. "Symptoms improve immediately after starting the medication." — It may take several weeks (1–3 weeks) to see improvement in symptoms after starting levothyroxine.
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Related Questions
Correct Answer is C
Explanation
A. Notifying the healthcare provider may be necessary, but only after the nurse gathers more assessment data to support the report.
B. Taking the pulse rate is part of a routine assessment but does not directly address the client's complaint of tight shoes, which may indicate fluid retention.
C. Weighing the client is the best initial action because sudden weight gain and tight shoes can indicate fluid overload, a common issue in clients with heart failure. Daily weights help assess fluid status.
D. Osler's maneuver is not relevant in this context; it’s a rarely used technique and not appropriate for assessing peripheral edema or fluid status.
Correct Answer is D
Explanation
A. Draw blood for an arterial blood gas — While ABG analysis is important in assessing respiratory function, it is not the priority in this emergency. The client is in severe respiratory distress and needs immediate intervention.
B. Initiate oxygen therapy as prescribed and reassess the client in 10 minutes — Although oxygen therapy is essential, waiting 10 minutes to reassess without addressing bronchoconstriction may delay critical treatment. Immediate bronchodilation is needed.
C. Encourage the client to relax and breathe slowly through the mouth — This may be helpful as a supportive measure but is not appropriate as the first intervention during acute respiratory distress.
D. Administer bronchodilators as prescribed — This is the priority action. The client is experiencing an acute asthma exacerbation, likely leading to airway constriction. Bronchodilators will help relieve bronchospasm and improve airflow, which is the most urgent need.
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