A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

A. Increased Hct. Propylthiouracil (PTU) is an antithyroid medication that reduces excessive thyroid hormone production in Graves' disease. It does not directly affect hematocrit (Hct) levels. While anemia can occur in some clients with untreated hyperthyroidism, PTU itself is not expected to raise Hct.

B. Decreased WBC count. A serious adverse effect of PTU is agranulocytosis, which results in a dangerously low white blood cell (WBC) count, increasing the risk of infection. However, this is a potential complication rather than an expected therapeutic outcome. Clients on PTU require regular monitoring of WBC levels to detect early signs of agranulocytosis.

C. Decreased heart rate. Graves’ disease causes hyperthyroidism, which increases metabolism and leads to symptoms such as tachycardia. PTU works by inhibiting thyroid hormone synthesis, leading to a gradual reduction in heart rate as thyroid function normalizes. This is a desired outcome of treatment, helping to reduce cardiovascular strain associated with hyperthyroidism.

D. Increased blood pressure. Hyperthyroidism can cause elevated blood pressure due to increased cardiac output. As PTU lowers thyroid hormone levels, blood pressure is expected to decrease or stabilize rather than increase. An increase in blood pressure would be unexpected and may indicate another underlying issue requiring evaluation.

A. Oatmeal. Oatmeal is a healthy carbohydrate and fiber source, but it is not a significant source of potassium, which is essential for clients taking furosemide. While beneficial for overall health, oatmeal will not help counteract potassium loss caused by diuretic therapy.

B. Baked potatoes. Baked potatoes are rich in potassium, which is frequently lost due to furosemide’s potassium-wasting effects. Furosemide is a loop diuretic that increases urine output and depletes electrolytes, particularly potassium, which can lead to hypokalemia (low potassium levels). To help maintain electrolyte balance, clients should consume potassium-rich foods like potatoes, bananas, oranges, and spinach.

C. Brown rice. Brown rice is a good source of fiber and complex carbohydrates, but it contains only small amounts of potassium. While it provides sustained energy, it does not significantly contribute to potassium replacement, making it less beneficial for clients on furosemide.

D. Eggs. Eggs are high in protein and essential nutrients but are not a significant source of potassium. While eggs are beneficial for overall health, they do not help replenish potassium lost due to diuretic therapy.