The nurse is caring for a client who has experienced head trauma in a motor vehicle accident.

The client is having excessive urine output.
Which medication should the nurse anticipate administering?

Choice A rationale:

It is not recommended to take levothyroxine with food as it can interfere with its absorption.

Food, particularly those containing calcium or iron, can bind to levothyroxine in the gastrointestinal tract, reducing the amount of medication that is absorbed into the bloodstream.

This can lead to decreased effectiveness of the medication.

It's generally advised to take levothyroxine on an empty stomach, at least 30-60 minutes before breakfast, to ensure optimal absorption.

Choice B rationale:

Taking levothyroxine first thing in the morning, on an empty stomach, is the most effective way to ensure its absorption and consistent hormone levels throughout the day.

This aligns with the body's natural rhythm of thyroid hormone production, which typically peaks in the morning hours.

Taking the medication consistently at the same time each day helps maintain stable thyroid hormone levels, which is crucial for managing hypothyroidism effectively.

Choice C rationale:

Relief of symptoms with levothyroxine therapy often takes several weeks, not just one week.

It takes time for the body to adjust to the medication and for thyroid hormone levels to reach a therapeutic range.

Patients should be counseled to have patience and continue taking the medication as prescribed, even if they don't experience immediate symptom relief.

They should also be monitored regularly by their healthcare provider to assess their response to treatment and make any necessary adjustments to the dosage.

Choice D rationale:

Doubling the dose of levothyroxine without consulting a healthcare provider is dangerous and can lead to serious health consequences.

Overdosing on levothyroxine can cause hyperthyroidism, which can manifest as rapid heart rate, anxiety, tremors, weight loss, and other health problems.

It's essential to follow the prescribed dosage and not make any changes without the guidance of a healthcare professional.

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.