A nurse is caring for a client in an outpatient clinic. Exhibits Complete the following sentence by using the lists of options. The client is at risk for dropdown due to dropdown

Levothyroxine is best absorbed on an empty stomach, typically taken 30–60 minutes before breakfast, and separately from other medications, especially multivitamins (iron and calcium) and esomeprazole (a proton pump inhibitor). The client has been taking levothyroxine after breakfast with other medications, which can interfere with its absorption. This leads to the risk of decreased therapeutic effectiveness, even though the current TSH is within normal range and free T4 is at the high end of normal. Multivitamins (often contain calcium or iron): Can bind to levothyroxine and reduce its absorption. Esomeprazole: Alters gastric pH, which can impair levothyroxine absorption. Food intake: Taking levothyroxine with food reduces its bioavailability.