An 84-year-old client with coronary artery disease has a new prescription for liothyronine 25 mcg daily. Which action should the nurse take?

1 Administer 50 mcg now because older adults with cardiac disease metabolize thyroid hormone more rapidly.
2 Hold and clarify the 25-mcg starting dose; older adults with cardiac disease should start at 5 mcg daily. ✓ Correct answer
3 Administer 25 mcg and wait until the next annual visit to assess for angina or other cardiac symptoms.
4 Crush the 25-mcg tablet into an enteral feeding because changing the route will reduce cardiac exposure.

Explanation

Older adults and clients with underlying cardiac disease should start liothyronine at 5 mcg daily and increase in 5-mcg increments to reduce cardiac adverse-reaction risk.

Next question on this topicA client is admitted to the emergency department after ingesting an unknown amount of acet…From this question bankL4-4. Pharmacology Safety TrainerKRW 18,000 · Free trial

In-depth explanation

Quick answer
Clarify the 25-mcg starting dose.

Why this is correct
Liothyronine can increase heart rate and contractility and precipitate angina or arrhythmia. The label specifies a 5-mcg daily start for older adults or clients with cardiac disease.

Easy analogy or mental picture
A sensitive engine starts at idle, not at highway speed.

Memory hook
Older heart: start T3 low and increase slowly.

NCLEX decision rule
Apply age and cardiovascular status before accepting the usual adult starting dose.

Why the other choices are wrong
Dose escalation and delayed monitoring increase cardiac risk, while an unverified route change does not solve the dose problem.

References

1DailyMed: Liothyronine SodiumFive-microgram start in older adults or cardiac disease

Clinical scenario

Thyroid replacement safety
Check age, coronary disease, baseline pulse and rhythm, starting dose, titration interval, and symptoms of overtreatment.

Browse all questions No login required

Master the NCLEX-RN with MyMerci

Thousands of NCLEX-style questions with detailed rationale — in your language. Track your progress and study smarter.

Start for free

App Store Google Play

Read in another language: English 한국어 日本語繁體中文 Tiếng Việt

For study reference only. Always follow current clinical guidelines and your institution’s protocols.

성장을 멈추지 마세요

An 84-year-old client with coronary artery disease has a new prescription for liothyronine 25 mcg daily. Which action should the nurse take?

In-depth explanation

Clinical scenario

Master the NCLEX-RN with MyMerci