A client has been taking propylthiouracil (PTU) for 8 weeks. Which statement by the client would indicate the drug is having its desired effects? (Select all that apply).
"My skin is not bruising as much."
“I am sleeping so much better."
"I don't feel as anxious as I once did."
“I can't seem to gain any weight no matter how much I eat."
"My menstruation is returning back to its regular cycle."
"My heart doesn't seem to be racing anymore."
Correct Answer : B,C,E,F
A. Bruising is typically related to anticoagulant effects or blood disorders and not directly tied to the desired effects of PTU.
B. Improved sleep is an indicator that hyperthyroidism symptoms, such as insomnia, are being managed effectively.
C. A decrease in anxiety can suggest effective management of hyperthyroidism, as anxiety is a common symptom of this condition.
D. Weight loss or inability to gain weight is usually a symptom of hyperthyroidism, so this statement would indicate that PTU is not achieving the desired effect.
E. A return to regular menstruation can indicate improved thyroid function, as hyperthyroidism can disrupt menstrual cycles.
F. Reduced heart rate and the absence of palpitations suggest effective management of hyperthyroidism symptoms, indicating the drug is having the desired effect.
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Correct Answer is C
Explanation
A. While liver failure may affect excretion indirectly, it primarily impacts metabolism more significantly.
B. Absorption is typically not directly affected by liver function, though it can be influenced by other factors.
C. The liver is crucial for drug metabolism; chronic liver failure impairs the liver's ability to metabolize medications effectively, leading to potential toxicity.
D. Distribution may be altered due to changes in plasma proteins or blood flow, but the most significant impact occurs in metabolism.
Correct Answer is C
Explanation
A. A pulse oximetry of 92% indicates mild hypoxia but does not directly contraindicate the use of verapamil.
B. A respiratory rate of 12 is within the normal range for adults and does not indicate a need to hold the medication.
C. A pulse of 78 is within the normal range but should be assessed in the context of the client’s overall condition; however, if the pulse were significantly lower (e.g., <60 bpm), it would necessitate holding the medication due to the risk of bradycardia.
D. A history of myocardial infarction a week ago would warrant caution but is not an absolute reason to hold verapamil unless other contraindications are present, as verapamil can be beneficial for managing hypertension post-MI.