The practical nurse (PN) notes that the pulse rate of a client newly started on levothyroxine sodium has increased from 98 to 120 beats/minute since the initial dose was administered the previous day. Which action should the PN implement?

A. Inform the client that the healthcare provider will need to increase the prescribed dose of levothyroxine sodium: An increased heart rate is a sign of excessive thyroid hormone activity. Increasing the dosage could worsen tachycardia and precipitate complications such as arrhythmias or cardiac strain. B. Hold the next dose of levothyroxine sodium and notify the charge nurse of the change in the client's pulse rate: Holding the next dose and promptly reporting to the charge nurse allows further evaluation and prevents potential cardiac complications from excessive thyroid hormone levels. C. Explain to the client that this is an expected side effect and administer the next dose of levothyroxine sodium as prescribed: A rise from 98 to 120 beats/minute is excessive and warrants concern. Continuing the medication without evaluation could exacerbate symptoms of hyperthyroidism, including palpitations and chest pain. D. Administer the scheduled dose of levothyroxine sodium unless the client's blood pressure is greater than 140/90 mm Hg: Blood pressure is not the most relevant indicator for levothyroxine dosage adjustment. The primary concern here is the elevated pulse rate, which signals potential overstimulation from the thyroid medication.