The nurse is teaching a client about levothyroxine. What information should be included? Select all that apply.

Rationale: A. "Common side effects include weight gain and lethargy.": Levothyroxine is a synthetic thyroid hormone that increases metabolic rate and energy. Common side effects of over-replacement include weight loss, nervousness, tremors, palpitations, and insomnia, not lethargy or weight gain. B. "Hold the dose if your resting heart rate is above 100 bpm.": Tachycardia can indicate excessive thyroid hormone levels, increasing the risk of arrhythmias or angina. Clients are advised to monitor their pulse and hold or notify the provider if the heart rate exceeds recommended limits, making this an important safety teaching point. C. "Take this drug early morning before the first meal.": Levothyroxine absorption is optimized when taken on an empty stomach, typically 30–60 minutes before breakfast. Food, especially calcium or iron, can interfere with absorption, so morning administration on an empty stomach is standard teaching. D. "Take this medication at bedtime to reduce risk for injury.": Bedtime dosing is generally not recommended because food or supplements consumed close to bedtime can impair absorption, reducing therapeutic effectiveness. Safety from injury is not a primary consideration in timing this medication. E. "You will only need to take this drug for a couple of weeks.": Levothyroxine is usually a lifelong therapy for primary hypothyroidism, as it replaces deficient thyroid hormone. Short-term use is not typical, so clients need to understand the long-term nature of therapy for effective management.