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 B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.
Correct Answer is C
Explanation
A. Glucose tablets are appropriate for clients with mild hypoglycemia who are alert and able to chew and swallow; they are not suitable for someone who is difficult to arouse.
B. Epinephrine is not used as a treatment for hypoglycemia; it does not directly increase blood glucose levels.
C. IVP (intravenous push) dextrose 50% is indicated for severe hypoglycemia in clients who are lethargic or unresponsive, as it rapidly increases blood glucose levels.
D. Orange juice is effective for mild hypoglycemia but is not appropriate in this case due to the client’s altered mental status and risk of aspiration.