The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms.
What change may need to be made to the client’s theophylline dose?
Decrease theophylline dosage immediately.
Decrease theophylline dose when normal thyroid function returns.
Discontinue the client’s theophylline.
Increase theophylline dosage immediately.
The Correct Answer is B
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This is because levothyroxine can increase the anticoagulant effect of oral anticoagulants and increase the risk of bleeding. The nurse should check the client’s prothrombin time and international normalized ratio (INR) regularly and report any abnormal values to the prescriber.
Choice B is wrong because hypothyroidism does not increase the risk of infection.
Choice C is wrong because hypothyroidism does not affect the level of consciousness unless it is severe and causes myxedema coma.
Choice D is wrong because hypothyroidism does not cause electrolyte imbalances.
Normal ranges for prothrombin time are 11 to 13.5 seconds and for INR are 0.8 to 1.22.
Correct Answer is C
Explanation
This is an antithyroid medication that can be used safely during pregnancy, as it has a lower risk of causing birth defects or fetal hypothyroidism than other drugs. Propylthiouracil inhibits the synthesis of thyroid hormones and also blocks their conversion to the more active form.
Choice A is wrong because radioactive iodine is contraindicated during pregnancy, as it can cross the placenta and damage the fetal thyroid gland.
Radioactive iodine is used to destroy overactive thyroid cells and treat hyperthyroidism.
Choice B is wrong because alendronate is not an antithyroid medication, but a bisphosphonate that is used to treat osteoporosis and prevent bone loss.
Alendronate should not be used during pregnancy, as it may affect fetal bone development and mineralization.
Choice D is wrong because methimazole is another antithyroid medication, but it is not the drug of choice for pregnant women, as it has a higher risk of causing birth defects or fetal hypothyroidism than propylthiouracil.
Methimazole also inhibits the synthesis of thyroid hormones, but does not block their conversion to the more active form.
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