A patient has been prescribed levothyroxine (Synthroid) for hypothyroidism. The patient inquires if the medication should be taken with food.
What would be the most appropriate response from the nurse?
Always consume this medication with food.
This medication should be taken with a glass of milk.
Consume this medication with juice and crackers.
This medication should be taken on an empty stomach.
The Correct Answer is D
Rationale for Choice A:
It is not recommended to always consume levothyroxine with food. In fact, food can interfere with the absorption of levothyroxine, leading to decreased efficacy of the medication.
Consuming levothyroxine with food can decrease its absorption by up to 30%, which can significantly impact its ability to manage hypothyroidism symptoms.
Certain foods, such as those high in fiber, calcium, or iron, can be particularly problematic, as they can bind to levothyroxine in the gut and further reduce its absorption.
While taking levothyroxine with a small amount of food may be necessary for some individuals who experience gastrointestinal side effects, it's generally recommended to take it on an empty stomach for optimal absorption.
Rationale for Choice B:
Milk is not an ideal beverage to take with levothyroxine, as it can also interfere with absorption. Milk contains calcium, which can bind to levothyroxine and reduce its absorption.
It's best to avoid consuming milk or other calcium-rich beverages within a few hours of taking levothyroxine.
Rationale for Choice C:
Similar to milk, juice and crackers are not ideal choices to take with levothyroxine.
Juice, especially those high in acidity, can affect the absorption of levothyroxine in the gut.
Crackers, often made with refined grains, can be high in fiber, which can also interfere with absorption.
Rationale for Choice D:
Taking levothyroxine on an empty stomach, typically 30-60 minutes before breakfast, is generally recommended to ensure optimal absorption.
This allows the medication to be absorbed more efficiently in the small intestine without being affected by the presence of food.
By taking levothyroxine on an empty stomach, patients can maximize its effectiveness in treating hypothyroidism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Mixing insulins in a vial is generally not recommended unless specifically instructed by the healthcare provider. It can alter the effectiveness of the insulins and increase the risk of dosage errors.
Premixed insulins, which are already combined in a specific ratio, are available if a combination of insulins is needed.
However, in this case, the patient is instructed to administer regular and NPH insulin separately, indicating that they should not be mixed in a vial.
Choice B rationale:
Insulin can be injected into various subcutaneous sites, including the abdomen, thighs, upper arms, and buttocks.
There is no specific requirement to inject mixed insulin into the buttocks only.
The choice of injection site can be based on individual preferences, absorption rates, and the presence of lipohypertrophy (thickening of the subcutaneous tissue due to repeated injections).
Choice C rationale:
Drawing up NPH insulin first could lead to contamination of the regular insulin vial with NPH insulin.
NPH insulin is a suspension, and drawing it up first could introduce some of its particles into the regular insulin vial, potentially altering its absorption and action profile.
Choice D rationale:
It's crucial to draw up the regular insulin first to prevent contamination of the regular insulin vial with NPH insulin. The following steps outline the correct procedure:
Wash hands thoroughly with soap and water.
Inspect the insulin vials for clarity, expiration date, and any damage.
Roll the NPH insulin vial gently between the palms to resuspend the insulin particles (if applicable). Wipe the rubber stoppers of both vials with an alcohol swab.
Using a sterile syringe, withdraw air into the syringe equal to the amount of regular insulin to be drawn.
Inject the air into the regular insulin vial, keeping the needle tip above the fluid level to avoid creating bubbles. Invert the regular insulin vial and withdraw the prescribed dose of regular insulin.
Without injecting air into the NPH insulin vial, withdraw the prescribed dose of NPH insulin. Administer the insulin as directed, using proper injection technique.
Correct Answer is C
Explanation
Choice A rationale:
Prednisolone is a corticosteroid that has anti-inflammatory and immunosuppressant effects. It does not have a direct effect on urine output.
While it may be used in some cases of head trauma to reduce inflammation, it would not be the first-line choice to address excessive urine output.
Prolonged use of prednisolone can have adverse effects such as fluid retention, weight gain, hypertension, and hyperglycemia.
Choice B rationale:
Corticotropin (ACTH) is a hormone that stimulates the adrenal glands to produce cortisol. Cortisol has a variety of effects, including increasing blood pressure and blood sugar levels.
It does not have a direct effect on urine output and would not be used to address this issue.
ACTH can have significant side effects, including fluid retention, electrolyte imbalances, and mood changes.
Choice C rationale:
Vasopressin is a hormone that regulates fluid balance in the body. It works by increasing water reabsorption in the kidneys, which can help to reduce urine output.
It is the most appropriate medication to administer to a client with excessive urine output following head trauma.
Vasopressin can be administered intravenously or subcutaneously. It is important to monitor the client's fluid intake and output closely when administering vasopressin, as it can lead to fluid overload if not used carefully.
Choice D rationale:
Calciferol is a form of vitamin D that helps to regulate calcium and phosphorus levels in the body. It does not have a direct effect on urine output.
It would not be used to address excessive urine output in a client with head trauma.
Excessive doses of calciferol can lead to hypercalcemia, which can cause kidney stones, bone pain, and other serious problems.
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