The healthcare provider prescribes propylthiouracil (PTU) and Lugol's solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?
Offer both drugs together with a meal.
Administer iodine one hour before PTU.
Schedule both medications at bedtime.
Give parental dose once every 24 hours.
The Correct Answer is B
A. Offer both drugs together with a meal:
Propylthiouracil (PTU) and Lugol's solution are typically not administered together with a meal. Lugol's solution, a strong iodine solution, is generally taken separately from PTU to avoid potential interactions and ensure optimal absorption of each medication.
B. Administer iodine one hour before PTU:
Lugol’s solution (iodine) is usually given before PTU because iodine can decrease the vascularity of the thyroid gland and make the thyroid gland less active, which helps PTU work more effectively. This timing helps optimize the therapeutic effects of both medications.
C. Schedule both medications at bedtime:
The timing of administration for PTU and Lugol’s solution is based on their specific interactions and pharmacokinetics rather than convenience. Scheduling them at bedtime does not align with the recommended practice for their optimal effectiveness.
D. Give parental dose once every 24 hours:
Both PTU and Lugol’s solution are not administered as a single dose every 24 hours. PTU is typically given multiple times per day to maintain effective blood levels, and Lugol’s solution is usually given as directed by the healthcare provider, often several times a day but not necessarily in a single 24-hour dose.
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Related Questions
Correct Answer is C
Explanation
A. Digoxin level of 1.1 ng/mL (1.4 nmol/L):
A digoxin level of 1.1 ng/mL is within the therapeutic range (0.8 to 2.0 ng/mL). While it is important to monitor digoxin levels, this value does not indicate an immediate concern.
B. Creatinine level of 0.8 mg/dL (70.72 μmol/L):
A creatinine level of 0.8 mg/dL is within the normal range (0.5 to 1.1 mg/dL) and does not indicate any renal impairment or immediate issue.
C. Potassium level of 3.2 mEq/L (3.2 mmol/L):
A potassium level of 3.2 mEq/L is below the normal range (3.5 to 5.0 mEq/L). Hypokalemia can increase the risk of digoxin toxicity and arrhythmias, making this an urgent issue that should be reported to the healthcare provider immediately.
D. Sodium level of 135 mEq/L (135 mmol/L):
A sodium level of 135 mEq/L is slightly below the normal range (136 to 145 mEq/L), but it is not as critical as a significantly abnormal potassium level in the context of digoxin use. While it should be monitored, it is less urgent compared to the potassium level.
Correct Answer is D
Explanation
A. Food diary shows increased consumption of iron-rich foods:
While iron-rich foods are important for managing anemia, this finding does not directly indicate the effectiveness of epoetin alfa. The primary measure of epoetin alfa's effectiveness is an improvement in hemoglobin levels, not dietary changes.
B. Reports of increased energy levels and decreased fatigue:
Increased energy and decreased fatigue are positive effects and may suggest that the medication is helping. However, these symptoms are subjective and not as definitive as a measurable increase in hemoglobin levels.
C. Takes concurrent iron therapy without adverse effects:
Iron therapy is often used alongside epoetin alfa to enhance its effectiveness, but the absence of adverse effects from iron therapy does not alone confirm the effectiveness of epoetin alfa. The key indicator is the improvement in hemoglobin levels.
D. Hemoglobin level increased to 12 g/dL (7.45 mmol/L):
An increase in hemoglobin level to 12 g/dL is a direct measure of the effectiveness of epoetin alfa. This increase demonstrates that the medication is successfully stimulating red blood cell production, which is the intended therapeutic effect.
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