A client who is 8 weeks pregnant takes methimazole for Graves disease. Which nursing action is most appropriate?

1 Tell the client to stop antithyroid therapy until after delivery.
2 Reassure the client that methimazole remains preferred during early pregnancy.
3 Add saturated potassium iodide and continue methimazole without clarification.
4 Notify 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.

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In-depth explanation

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.

References

1FDA: Propylthiouracil prescribing informationFirst-trimester preference, methimazole fetal risk, and PTU liver warning

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A client who is 8 weeks pregnant takes methimazole for Graves disease. Which nursing action is most appropriate?

In-depth explanation

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