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 C
Explanation
Propylthiouracil (PTU) is an antithyroid drug that blocks the synthesis of thyroid hormones by interfering with the oxidation of iodine and the coupling of iodotyrosines.
This reduces the levels of triiodothyronine (T) and thyroxine (T) in the blood and relieves the symptoms of hyperthyroidism.
Choice A is wrong because PTU does not destroy any part of the thyroid gland.
It only inhibits the production of thyroid hormones within the gland.
Choice B is wrong because PTU does not suppress the anterior pituitary gland’s secretion of thyroid-stimulating hormone (TSH).
TSH is a hormone that stimulates the thyroid gland to produce thyroid hormones.
PTU does not affect the feedback loop between the hypothalamus, pituitary, and thyroid glands.
Choice D is wrong because PTU does not suppress the hypothalamus’s production of thyrotropin-releasing hormone (TRH).
TRH is a hormone that stimulates the pituitary gland to secrete TSH.
PTU does not affect the feedback loop between the hypothalamus, pituitary, and thyroid glands.
Normal ranges for T are 80 to 220 ng/dL, for T are 4.5 to 11.2 mcg/dL, and for TSH are 0.4 to 4.0 mIU/L.
Correct Answer is B
Explanation
Levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. It should be taken on an empty stomach, preferably in the morning, with a full glass of water to facilitate absorption and prevent choking. Taking the medication with food or other substances may interfere with its effectiveness.
Choice A is wrong because levothyroxine does not need to be taken after breakfast.
In fact, taking it after breakfast may reduce its absorption and efficacy.
Choice C is wrong because levothyroxine does not require the patient to remain in the upright position for 30 minutes after administering.
This instruction is more applicable to bisphosphonates, which are drugs used to treat osteoporosis.
Choice D is wrong because levothyroxine should not be taken at night.
Taking it at night may cause insomnia, as well as reduced absorption and efficacy.
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