Which medication, if taken within the last 24-48 hours, would prevent a nurse from administering nitroglycerin?

Choice A rationale:

It is not recommended to take levothyroxine with food as it can interfere with its absorption.

Food, particularly those containing calcium or iron, can bind to levothyroxine in the gastrointestinal tract, reducing the amount of medication that is absorbed into the bloodstream.

This can lead to decreased effectiveness of the medication.

It's generally advised to take levothyroxine on an empty stomach, at least 30-60 minutes before breakfast, to ensure optimal absorption.

Choice B rationale:

Taking levothyroxine first thing in the morning, on an empty stomach, is the most effective way to ensure its absorption and consistent hormone levels throughout the day.

This aligns with the body's natural rhythm of thyroid hormone production, which typically peaks in the morning hours.

Taking the medication consistently at the same time each day helps maintain stable thyroid hormone levels, which is crucial for managing hypothyroidism effectively.

Choice C rationale:

Relief of symptoms with levothyroxine therapy often takes several weeks, not just one week.

It takes time for the body to adjust to the medication and for thyroid hormone levels to reach a therapeutic range.

Patients should be counseled to have patience and continue taking the medication as prescribed, even if they don't experience immediate symptom relief.

They should also be monitored regularly by their healthcare provider to assess their response to treatment and make any necessary adjustments to the dosage.

Choice D rationale:

Doubling the dose of levothyroxine without consulting a healthcare provider is dangerous and can lead to serious health consequences.

Overdosing on levothyroxine can cause hyperthyroidism, which can manifest as rapid heart rate, anxiety, tremors, weight loss, and other health problems.

It's essential to follow the prescribed dosage and not make any changes without the guidance of a healthcare professional.

Choice A Rationale:

NPH insulin can be mixed with certain other insulins, such as regular insulin, to achieve different effects and better control blood glucose levels. Therefore, stating that it should never be mixed with another insulin is incorrect.

Choice C rationale:

NPH insulin is an intermediate-acting insulin that can be administered at various times of the day, depending on the individual's needs and blood glucose patterns. It is not restricted to bedtime administration only.

Choice D rationale:

When mixing NPH insulin with another insulin, the order of mixing does not significantly affect its action. The crucial aspect is to ensure proper mixing of the insulins before administration.

Choice B rationale:

NPH insulin is a suspension, meaning the insulin particles are not fully dissolved in the liquid. Therefore, it's essential to roll the vial gently between the palms to evenly distribute the insulin particles throughout the solution. This ensures that the patient receives the correct dose and prevents injection of an uneven mixture, which could lead to unpredictable blood glucose levels.

Key points to remember:

NPH insulin is an intermediate-acting insulin that starts working within 1 to 2 hours, peaks in 4 to 12 hours, and lasts for 12 to 18 hours.

It can be mixed with regular insulin to provide both short-acting and longer-acting insulin coverage. Always follow the specific instructions provided by the insulin manufacturer and healthcare provider. Proper mixing of NPH insulin is crucial for accurate dosing and optimal glucose control.