When providing teaching for a patient who is prescribed a selective serotonin reuptake inhibitor (SSRI), which statement will the nurse include?

Choice A rationale

Radioactive iodine (RAI) therapy involves the patient ingesting a capsule containing iodine-131, which targets and destroys overactive thyroid cells. The patient's bodily fluids, including saliva, sweat, and urine, become temporarily radioactive. To protect others, especially pregnant women and young children who are more susceptible to radiation, close contact must be avoided for several days to a week.

Choice B rationale

Continuing thyroid medication is incorrect. Antithyroid medications like propylthiouracil or methimazole, used to manage hyperthyroidism, must be stopped several days before radioactive iodine therapy. These drugs can interfere with the uptake of the radioactive iodine by the thyroid gland, reducing the effectiveness of the treatment. This is a crucial instruction for treatment success.

Choice C rationale

A high-iodine diet is incorrect. The patient is instructed to follow a low-iodine diet for one to two weeks before the procedure. A low-iodine diet depletes the body's iodine stores, making the thyroid gland "hungry" for iodine. This enhanced uptake ensures that the radioactive iodine is more effectively absorbed by the thyroid cells, increasing treatment efficacy.

Choice D rationale

Increased fluid intake is a correct instruction. Consuming a generous amount of fluids after the procedure helps to flush any unabsorbed radioactive iodine out of the body through the urinary system. This helps to reduce the radiation exposure to other organs and tissues, particularly the salivary glands and the bladder, and minimizes side effects.

Choice E rationale

A low-iodine diet is a correct instruction. As noted in the rationale for choice C, a low-iodine diet is essential for maximizing the uptake of the radioactive iodine by the thyroid gland. By decreasing the body's circulating iodine levels, the thyroid gland becomes more receptive to the radioactive iodine, thereby enhancing the therapeutic effect of the treatment.

Choice F rationale

Prolonged intimate contact should be avoided. Due to the temporary radioactivity of body fluids and sweat, close contact, including kissing and sexual intercourse, should be avoided for several days to a week. The patient must also avoid sharing utensils and using separate bathrooms to prevent transferring radioactive material to others, particularly vulnerable individuals.

Choice A rationale

Discontinuing the medication should never be a unilateral nursing decision, as beta-blockers must be tapered off gradually to prevent rebound hypertension, reflex tachycardia, or an acute myocardial infarction. Abrupt cessation can cause a sudden increase in heart rate and blood pressure, putting the patient at significant risk.

Choice B rationale

Fatigue and cold extremities are recognized side effects of beta-blockers, which work by blocking beta-adrenergic receptors, leading to decreased heart rate and vasodilation. Assessing vital signs, especially heart rate and blood pressure, helps determine the severity of the symptoms and whether the medication's therapeutic effects are too pronounced, warranting a dose adjustment by the provider.

Choice C rationale

Increasing the dose would likely worsen the patient's fatigue and cold extremities. These symptoms are dose-dependent effects of beta-blockers, and a higher dose would intensify the medication's physiological impact, leading to a more pronounced decrease in cardiac output and peripheral circulation, exacerbating the patient's discomfort.

Choice D rationale

While rest may provide temporary relief for fatigue, it does not address the underlying pharmacological cause of the symptoms. The patient's fatigue is a direct result of the medication's effect on heart rate and cardiac output. The more appropriate nursing action is to report the findings to the provider for a potential medication or dose change.