The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms.
What change may need to be made to the client’s theophylline dose?
Decrease theophylline dosage immediately.
Decrease theophylline dose when normal thyroid function returns.
Discontinue the client’s theophylline.
Increase theophylline dosage immediately.
The Correct Answer is B
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.
Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.
Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.
Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.
Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.
Correct Answer is B
Explanation
The client should avoid taking aspirin while taking corticosteroids because of the potential drug-drug interaction between them. This interaction may cause a reduction in the blood levels of aspirin and decrease its effectiveness. It may also increase the risk of gastrointestinal side effects such as inflammation, bleeding, ulceration, and perforation.
Choice A is wrong because dimenhydrinate is an antihistamine that is used to prevent and treat nausea, vomiting, and dizziness.
It does not have a significant interaction with corticosteroids.
Choice C is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain, inflammation, and fever.
It has a similar interaction with corticosteroids as aspirin, but it is less potent and less likely to cause bleeding.
Choice D is wrong because famotidine is a histamine-2 receptor antagonist that is used to treat and prevent ulcers, gastroesophageal reflux disease (GERD), and other conditions that cause excess stomach acid.
It does not have a significant interaction with corticosteroids.
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