A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

Correct Answer: D

Rationale: In the case of a client with Hypothyroidism starting Levothyroxine in a long-term care facility, the nurse should expect the dosage schedule to start with a low dose (Option D) that will be gradually increased. This is the correct answer because initiating treatment for Hypothyroidism with Levothyroxine typically involves a cautious approach to prevent adverse effects like cardiac complications or hyperthyroidism. Option A, starting at a high dose and tapering, is incorrect because it poses a higher risk of adverse effects and does not align with standard practice guidelines for Levothyroxine initiation. Option B, remaining on the initial dosage, is also incorrect as dosages are usually adjusted based on the client's response to treatment. Option C, adjusting the dosage daily based on blood levels, is not typically done as it takes time for Levothyroxine to reach therapeutic levels in the body. From an educational perspective, understanding the rationale behind the gradual increase in Levothyroxine dosage is crucial for nursing practice. It ensures safe and effective medication management, highlights the importance of monitoring for signs of hyperthyroidism or cardiac issues, and emphasizes the need for ongoing assessment and dosage adjustments based on the client's clinical response. This approach aligns with evidence-based pharmacological principles and promotes optimal client outcomes in the long-term care setting.

Correct Answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa as it is a common adverse effect caused by increased red blood cell production. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Monitoring blood pressure is crucial to detect and manage hypertension promptly.

Correct Answer: C

Rationale: The nurse should monitor the client for gynecomastia, as it is an adverse effect of leuprolide due to decreased testosterone levels. Leuprolide works by decreasing testosterone production, which can lead to gynecomastia, the development of male breast tissue. Monitoring for this side effect is essential for early detection and intervention.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Gynecomastia. Bicalutamide is an androgen receptor antagonist commonly used in the treatment of prostate cancer. Gynecomastia, the development of breast tissue in males, is a well-known adverse effect of bicalutamide due to its anti-androgenic properties. It is crucial for the nurse to educate the client on monitoring for signs of gynecomastia to ensure early detection and intervention. Muscle pain (option A) is not typically associated with bicalutamide use and is therefore not a priority adverse effect to monitor. Flushing (option B) is also not a common side effect of bicalutamide and is unlikely to occur. Hyperglycemia (option D) is not directly related to bicalutamide use and is more commonly associated with other medications or conditions. In an educational context, understanding the adverse effects of medications is essential for nurses to provide safe and effective care to their clients. By knowing the expected side effects of specific drugs, nurses can educate clients on what to monitor for and when to seek medical attention. This knowledge enhances patient safety and promotes better outcomes in pharmacological therapy.

Correct Answer: A

Rationale: In pharmacology, understanding the side effects and adverse reactions of medications is crucial for safe and effective patient care. When starting therapy with trastuzumab, a monoclonal antibody used to treat certain types of cancer, the nurse should instruct the client to report dyspnea immediately. Dyspnea can be a sign of a serious side effect called cardiomyopathy, which is a known risk associated with trastuzumab therapy. Cardiomyopathy can lead to potentially life-threatening complications if not addressed promptly. The other options (B) Constipation, (C) Tinnitus, and (D) Dry mouth are less concerning side effects compared to dyspnea when starting trastuzumab therapy. Constipation is a common gastrointestinal side effect, tinnitus is not typically associated with trastuzumab, and dry mouth is a minor side effect that does not pose immediate serious risks to the client's health. Educationally, this question highlights the importance of recognizing and prioritizing potential side effects of medications to ensure patient safety. Nurses need to be vigilant in educating clients about signs and symptoms that warrant immediate attention to prevent serious complications and promote positive treatment outcomes.