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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Tolbutamide is preferred for clients with renal dysfunction, who may not be able to excrete chlorpropamide, because it is more easily cleared from the body.

Choice B. Tolazamide is wrong because it is a first-generation sulfonylurea that is used less frequently and is usually tried after tolbutamide and chlorpropamide have been shown to be ineffective.

Choice C. Chlorpropamide is wrong because it is a first-generation sulfonylurea that may accumulate in clients with renal dysfunction and cause hypoglycemia.

Choice D. Chlorpromazine is wrong because it is an antipsychotic agent, not an oral antidiabetic agent.

First-generation sulfonylureas are oral antidiabetic agents that stimulate insulin secretion from the pancreas.

They are used to treat type 2 diabetes mellitus.

The normal range of blood glucose level is 70 to 110 mg/dL.

A. A client being treated for a traumatic brain injury. B. A client with a history of ischemic heart disease. C. A pediatric client. D. A client with type 2 diabetes.

Correct Answer is A

Explanation

This is because phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines can cause central nervous system effects such as drowsiness, dizziness, and extrapyramidal symptoms that may worsen the condition of a client with a brain injury.

Choice B is wrong because phenothiazines are not contraindicated in clients with ischemic heart disease.

However, they should be used with caution as they can cause hypotension and cardiac arrhythmias.

Choice C is wrong because phenothiazines are not contraindicated in pediatric clients.

However, they should be used with caution as they can cause sedation, anticholinergic effects, and paradoxical excitement.

Choice D is wrong because phenothiazines are not contraindicated in clients with type 2 diabetes.

However, they should be used with caution as they can cause hyperglycemia and alter the effects of antidiabetic drugs.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with renal dysfunction who requires an oral antidiabetic agent. What drug will the nurse expect to see ordered?

Correct Answer is A

Explanation

For which client would the use of a phenothiazine most likely be contraindicated?

Correct Answer is A

Explanation

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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?