A patient diagnosed with hyperthyroidism is about to start antithyroid medication therapy. Which food should the patient avoid as advised by the nurse?
Fava beans
Shellfish
Foods high in purine
Grapefruit
The Correct Answer is D
Choice A rationale:
Fava beans do not interact with antithyroid medications and do not need to be avoided specifically for this reason. However, it's important to note that fava beans can cause a condition called favism in individuals with a certain genetic predisposition. Favism is characterized by hemolytic anemia, which is the breakdown of red blood cells. If a patient has a history of favism or is unsure of their risk, it's best to avoid fava beans while on antithyroid medication and consult with their healthcare provider.
Choice B rationale:
Shellfish does not typically interact with antithyroid medications. However, some individuals with hyperthyroidism may have co-existing allergies to shellfish. In those cases, it's important to avoid shellfish to prevent allergic reactions, but this is not due to a direct interaction with antithyroid medications.
Choice C rationale:
Foods high in purine, such as organ meats, red meat, and certain seafood, are often restricted in individuals with gout. Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints. While hyperthyroidism can sometimes increase uric acid levels, there's no specific interaction between antithyroid medications and purine-rich foods. Therefore, avoiding purine- rich foods is not necessary for those on antithyroid therapy unless they have gout or a predisposition to it.
Choice D rationale:
Grapefruit and grapefruit juice can significantly interact with antithyroid medications, particularly methimazole and propylthiouracil. These medications are broken down by an enzyme called CYP3A4 in the liver. Grapefruit juice inhibits the activity of CYP3A4, which can lead to increased levels of antithyroid medications in the bloodstream. This can increase the risk of side effects from the medication, such as liver damage, bone marrow suppression, and skin reactions. Therefore, it's crucial for patients on antithyroid therapy to avoid grapefruit and grapefruit juice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale for A:
Regular insulin is the only insulin formulation that can be safely administered intravenously. It is a rapid-acting insulin that starts working within 15 minutes and peaks in 1-2 hours, making it ideal for urgent glucose control in situations like diabetic ketoacidosis.
NPH insulin is an intermediate-acting insulin that is not suitable for IV administration. It is designed to be absorbed slowly over several hours, and injecting it intravenously could lead to unpredictable and potentially dangerous fluctuations in blood glucose levels.
Subcutaneous (SQ) injection is the standard route of administration for both regular and NPH insulin outside of acute care settings. This route allows for a more gradual and consistent absorption of insulin, which is essential for maintaining stable blood glucose control.
The patient's transfer to the med/surg unit indicates that their condition has stabilized and no longer requires the aggressive glucose control that is achieved with an IV insulin infusion. Therefore, it is appropriate to transition them to SQ insulin injections.
Rationale for B:
While mixing insulins can potentially alter their absorption rates and action profiles, the primary concern with mixing NPH and regular insulin is not an increased risk of hypoglycemia. It is the incompatibility of the formulations for IV administration.
Rationale for C:
NPH and regular insulin can be mixed together for subcutaneous injection, but they are not compatible for intravenous administration.
Rationale for D:
While NPH insulin can be administered as part of an IV insulin drip in the ICU, this is typically done in specific situations where a continuous infusion of both rapid-acting and intermediate-acting insulin is required. It is not the standard practice for NPH insulin administration.
Correct Answer is B
Explanation
Choice A rationale:
Increasing the amiodarone infusion rate would worsen the patient's bradycardia and hypotension. Amiodarone is a class III antiarrhythmic drug that works by prolonging the action potential duration in cardiac cells. This can lead to a decrease in heart rate and contractility.
Increasing the dose in this patient could lead to further hemodynamic compromise.
Choice B rationale:
Decreasing the amiodarone infusion rate is the most appropriate action in this situation. This will help to mitigate the drug's effects on the patient's heart rate and blood pressure.
A dose reduction may allow the heart rate to recover to a safer level while still maintaining the antiarrhythmic benefits of amiodarone.
Choice C rationale:
Continuing the amiodarone infusion at the current rate is not appropriate, as it is likely to worsen the patient's bradycardia and hypotension.
Maintaining the current dose could lead to further clinical deterioration.
Choice D rationale:
Discontinuing the amiodarone infusion entirely may not be necessary at this point. The patient's arrhythmia may still require treatment with amiodarone.
A dose reduction may be sufficient to address the patient's hemodynamic instability while still providing therapeutic benefits.
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