A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?

Choice A rationale:

Liothyronine (Cytomel) is a type of thyroid hormone used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. However, it is not typically used to treat hyperthyroidism.

Choice B rationale:

Liotrix (Thyrolar) is a combination of two thyroid hormones, levothyroxine (T4) and liothyronine (T3), used to treat hypothyroidism, and to prevent and treat goiter. Similar to Liothyronine, it is not typically used to treat hyperthyroidism. Choice C rationale:

Levothyroxine (Synthroid) is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone helps maintain normal mental and physical activity. In children, having enough thyroid hormone helps them grow and learn normally.

Choice D rationale:

Propylthiouracil (Propacil) is an antithyroid agent used in the treatment of hyperthyroidism. It works by decreasing the amount of thyroid hormone produced by the thyroid gland. This helps to prevent the excessive heat, rapid heart rate, and nervousness caused by too much thyroid hormone in the body.

Choice A rationale:

Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. However, one of the key reasons aspirin is administered to a patient with a history of myocardial infarction (MI) is due to its antiplatelet aggregate properties. This effect reduces the risk of stroke and heart attack. If a patient has recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), doctors may direct them to use aspirin in low doses as a “blood thinner” to prevent blood clots.

Choice B rationale:

While aspirin does have analgesic properties, meaning it can relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches, this is not the primary reason it would be administered to a patient with a history of MI. The main goal in this context is to prevent further cardiac events, which is achieved through aspirin’s antiplatelet effects.

Choice C rationale:

Aspirin does have anti-inflammatory properties and it may be used to reduce pain and swelling in conditions such as arthritis. However, in the context of a patient with a history of MI, the anti-inflammatory property is not the primary reason for administering aspirin. The key purpose is to leverage its antiplatelet effects to prevent further cardiac events.

Choice D rationale:

Aspirin can be used to reduce fever, which is what the term ‘antipyretic’ refers to. However, similar to the analgesic and antiinflammatory properties, the antipyretic property is not the primary reason for administering aspirin to a patient with a history of MI. The main goal is to prevent further cardiac events through its antiplatelet effects.