A client who is 8 weeks pregnant takes methimazole for Graves disease. Which nursing action is most appropriate?
1Tell the client to stop antithyroid therapy until after delivery.
2Reassure the client that methimazole remains preferred during early pregnancy.
3Add saturated potassium iodide and continue methimazole without clarification.
4Notify the prescriber to discuss PTU for the first trimester and reassess therapy later.✓ Correct answer
Explanation
Propylthiouracil is generally preferred during the first trimester because methimazole has been associated with fetal abnormalities. Because propylthiouracil can cause severe liver injury, the regimen should be reassessed after the first trimester rather than changed independently by the nurse.
Quick answer Clarify the regimen: PTU is preferred in the first trimester.
Why this is correct Methimazole exposure early in pregnancy has been linked to characteristic fetal abnormalities. PTU is preferred in the first trimester, followed by later reassessment because PTU carries a serious hepatotoxicity risk.
Easy analogy or mental picture The safer antithyroid choice changes as pregnancy moves from early organ formation to later gestation.
Memory hook First trimester: PTU; later: reassess.
NCLEX decision rule When pregnancy changes the preferred medication, hold administration only as clinically indicated and contact the prescriber rather than independently switching therapy.
Why the other choices are wrong Untreated hyperthyroidism is dangerous, methimazole is not preferred early in pregnancy, and iodide should not be added without a specific indication and prescription.