A client has been taking thyroid hormone replacement for several ...

[armygirl]

A client has been taking thyroid hormone replacement for several years. On today's clinic visit, the nurse remarks that the client has lost 20 pounds. The client states, I was getting fat, so I started taking an extra thyroid pill every day or so.
 
  How should the nurse respond?
  1. Well, it certainly is working for you.
  2. You should follow the dosage instructions for your thyroid medication exactly as written.
  3. I'll ask your physician to increase the number of refills on your prescription.
  4. That could be dangerous to your health.
  5. I may ask the doctor to write a prescription for me.

Question 2

A client will be prescribed an oral corticosteroid for treatment of a rash. The prescriber says, In order to avoid adverse effects, I am prescribing the smallest amount possible.
 
  What other prescribing regimens could the nurse suggest to achieve this same effect?
  1. Give the oral medication every other day.
  2. Administer a larger dose for a few days and then gradually decrease the dose until the medication is discontinued.
  3. Use a topical application instead of an oral product.
  4. Start with a small dose and work up to the desired dose.
  5. Administer the doses intramuscularly for the first few days of treatment.

[cascooper22]

Answer to Question 1

Correct Answer: 2,4
Rationale 1: Thyroid medications should not be used in this manner.
Rationale 2: Thyroid medications are of various strengths and should be taken as prescribed.
Rationale 3: The nurse should not provide additional medication to this client.
Rationale 4: Taking excess thyroid medication is dangerous.
Rationale 5: The nurse should not encourage the misuse of prescription medications.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: Alternate day administration can limit adrenal atrophy.
Rationale 2: There are specific formulations of corticosteroids that are packaged for use of a large dose initially which is then tapered off until all the medication is gone.
Rationale 3: Topical application does not cause as many systemic effects as oral dosage.
Rationale 4: Corticosteroid doses are generally started high and worked down to discontinuance.
Rationale 5: Using a less systemic approach would lessen effects.

[armygirl]

Thanks for the timely response, appreciate it

[kjohnson]

Excellent