The nurse is working with a client who is newly diagnosed with hypothyroidism. Diagnostic testing has indicated that the client’s health problem is caused by anterior pituitary dysfunction.
This client’s hypothyroidism is rooted in a deficiency of:

The nurse should ask this question because the client is taking a chemical stimulant laxative, which can cause dehydration and electrolyte imbalance, especially in combination with medications for heart failure and osteoarthritis that may also affect fluid and electrolyte balance. The nurse should assess the client’s hydration status and risk of hypovolemia or hypotension.

Choice B. Timing of medication administration is wrong because it is not the priority question in this situation.

The nurse should ask this question later to determine if the client is taking the medications as prescribed and if there are any drug interactions or adverse effects.

Choice C. Previous effectiveness of laxatives is wrong because it is not relevant to the client’s current condition.

The nurse should ask this question later to evaluate the client’s bowel habits and history of constipation.

Choice D. The amount of fiber intake is wrong because it is not the priority question in this situation.

The nurse should ask this question later to educate the client about dietary measures to prevent constipation and promote bowel health.

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.