A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism.
The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hr of taking levothyroxine?

Choice A rationale:

Spreading the ointment in a 10 cm² (4 in) area is not the recommended method for nitroglycerin ointment application. The ointment should be applied over a 6x inch area in a thin, uniform layer.

Choice B rationale:

Massaging the ointment into the skin is not advised. The ointment should be applied in a thin layer and left to absorb into the skin.

Choice C rationale:

Applying the ointment in a thick layer is not recommended. A thin, uniform layer is sufficient for therapeutic effect.

Choice D rationale:

Covering the administration area with plastic wrap is the correct action. This helps to keep the ointment in place and enhances absorption.

Choice A rationale:

Hypernatremia (high sodium levels) is not a common side effect of spironolactone. Spironolactone is a potassium-sparing diuretic and does not typically affect sodium levels.

Choice B rationale:

Hyperkalemia (high potassium levels) is a potential adverse effect of spironolactone. As a potassium-sparing diuretic, spironolactone can cause an increase in serum potassium levels.

Choice C rationale:

Hypophosphatemia (low phosphate levels) is not typically associated with spironolactone use.

Choice D rationale:

Hypocalcemia (low calcium levels) is also not a common side effect of spironolactone.