An older adult client with hypothyroidism has been prescribed levothyroxine. What instructions should the nurse provide?

Choice A rationale

It is important for a client with diabetes mellitus to test the temperature of the water before bathing to prevent burns. People with diabetes often have neuropathy, which can reduce their ability to feel temperature changes, especially in their extremities. Therefore, using the wrist, which is more sensitive to temperature changes, can help ensure the water is not too hot.

Choice B rationale

Applying a heating pad to the feet is not recommended for people with diabetes. This is because the heat can cause burns, especially in those with neuropathy who may not be able to feel how hot the pad is.

Choice C rationale

Rounding the corners of toenails with a nail file is not recommended as it can lead to ingrown toenails. Instead, toenails should be cut straight across to avoid this.

Choice D rationale

While it’s important to keep skin moisturized to prevent dryness and cracking, lotion should not be applied between the toes. This area can stay moist and warm, creating an ideal environment for fungal infections.

Choice A rationale

Diltiazem is a calcium channel blocker used to treat high blood pressure and prevent chest pain (angina). It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart. The sustained-release tablets are designed to release the medication slowly in the body. Therefore, patients are advised to consume the medication in its entirety. Crushing, chewing, or breaking the tablet would cause too much of the drug to be released at one time.

Choice B rationale

While it’s generally a good idea to store medications in a cool, dry place, specific storage instructions for diltiazem sustained-release tablets are not typically emphasized. The focus is more on the method of consumption.

Choice C rationale

Grapefruit and grapefruit juice may interact with diltiazem and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Therefore, it’s not advisable to accompany the medication with grapefruit juice.

Choice D rationale

Diltiazem can be taken with or without food. If it upsets the patient’s stomach, it can be taken with food. However, it’s not a mandatory instruction that the medication must be administered during meals.