The nurse is caring for a client during treatment of myxedema and the client reports experiencing chest pain. Which of the following actions should be a priority for the nurse to take?

Administer prescribed morphine sulphate.

Stop thyroid hormone administration.

Obtain serum cardiac enzymes.

Complete a pain assessment.

Answer and Explanation

The Correct Answer is D

A. While morphine may be indicated for pain management, particularly if the pain is severe, the priority is first to assess the cause of the chest pain. Chest pain in a patient with myxedema could be related to a number of serious conditions, such as a myocardial infarction or worsening cardiovascular issues, so it is important to assess the pain thoroughly before administering any medications.
B. Stopping thyroid hormone administration is not the correct action. Myxedema is a severe form of hypothyroidism, and thyroid hormone therapy is essential in treating this condition. However, if there is a concern about the cause of the chest pain (such as a heart attack), stopping the thyroid hormone might not be appropriate unless directly indicated by a physician.
C. While obtaining cardiac enzymes can be an important diagnostic step if the chest pain is suspected to be related to a cardiac event, the priority at this moment is to assess the pain and clinical presentation more thoroughly. Cardiac enzymes can be checked after a full assessment of the symptoms.
D. The first priority is to complete a comprehensive pain assessment. The nurse should assess the quality, intensity, and duration of the chest pain and ask relevant questions to determine if the pain is cardiac in nature (e.g., tightness, radiating to left arm, sweating) or possibly related to the thyroid condition (e.g., could be related to complications of myxedema, such as hypothyroid-induced cardiac dysfunction). This step is critical to understanding the cause and ensuring appropriate next steps for care.

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Correct Answer is D

Explanation

A. Carbidopa does not directly prevent dyskinesia. Dyskinesia is often a side effect of long-term levodopa therapy. Carbidopa’s role is to help optimize the effectiveness of levodopa and reduce side effects, but it does not specifically prevent dyskinesia.
B. The combination of levodopa and carbidopa does not prevent drug tolerance. Drug tolerance refers to the reduced effect of a drug over time, and while the combination may help with optimal absorption and effectiveness, it doesn't directly address tolerance.
C. While carbidopa helps reduce some side effects (such as nausea and vomiting) by preventing the peripheral breakdown of levodopa, the primary purpose of combining the two drugs is not solely to prevent side effects but to improve levodopa's effectiveness and absorption in the brain.
D. Carbidopa inhibits the enzyme aromatic L-amino acid decarboxylase (AADC) in the peripheral tissues, preventing the premature breakdown (metabolism) of levodopa into dopamine before it reaches the brain. This allows more levodopa to enter the brain and be converted into dopamine, enhancing the therapeutic effect for Parkinson's disease.

A. magnesium hydroxide (Milk of Magnesia) B. amitriptyline (Elavil) C. acetaminophen (Tylenol) D. gabapentin (Neurontin)

Correct Answer is A

Explanation

A. Magnesium hydroxide can interfere with the absorption of levothyroxine (Synthroid) and reduce its effectiveness. The nurse should notify the healthcare provider if the client is taking magnesium hydroxide or any other antacid that contains magnesium, calcium, or aluminum because these can decrease the absorption of levothyroxine.
B. While amitriptyline (an antidepressant) may interact with other medications, it does not typically interfere with levothyroxine. However, the nurse should always be cautious about potential interactions, especially with medications that affect the central nervous system.
C. Acetaminophen (Tylenol) does not typically interact with levothyroxine. It is safe to take acetaminophen while on levothyroxine.
D. Gabapentin (Neurontin) does not generally interfere with levothyroxine absorption or action. However, as with any medication, the nurse should be aware of other potential interactions based on the client’s overall health.

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The nurse is caring for a client during treatment of myxedema and the client reports experiencing chest pain. Which of the following actions should be a priority for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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