The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse.

While performing a head-to-toe assessment, the nurse discovers four patches on the client’s body. Which action should the nurse take first?

Levothyroxine is a thyroid hormone replacement medication used to treat hypothyroidism. To ensure proper absorption and effectiveness of the medication, it should be taken on an empty stomach, preferably in the morning, and at least 30 minutes before eating. Therefore, when the client indicates that they understand the need to take the medication on an empty stomach, it indicates that the education was effective.

Option b, "Avoid the use of iron supplements," is also important education for clients taking levothyroxine because iron supplements can interfere with the absorption of the medication. However, it is not the best indicator of effective education because the question asks for the statement that indicates education was effective, and option a is a more direct and specific response to the medication.

Option c, "Administer levothyroxine at bedtime," is not accurate information because the medication should be taken in the morning on an empty stomach.

Option d, "Consume foods that are high in iodine," is not recommended for clients taking levothyroxine because high amounts of iodine can interfere with thyroid function. Therefore, this statement indicates a need for further education.

Epoetin alfa is a medication that stimulates the production of red blood cells and is commonly used to treat anemia in patients with chronic kidney disease. Hemoglobin level is the most important parameter to monitor the effectiveness of epoetin alfa therapy. An increase in hemoglobin level indicates an improvement in the patient's anemia and suggests that the medication is effective.

While options a, b, and d are also important considerations in the management of anemia, they do not provide a definitive indication of the effectiveness of epoetin alfa therapy. Reports of increased energy levels and decreased fatigue can be subjective and influenced by many factors. Taking concurrent iron therapy without adverse effects is important to support the production of red blood cells but does not confirm the effectiveness of epoetin alfa. Increased consumption of iron-rich foods can be helpful in managing anemia, but it does not provide a direct indication of the effectiveness of epoetin alfa therapy.