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Question of The Day

A nurse is providing teaching for a client who will undergo a thyroidectomy. How should the nurse advise the client concerning the Lugol solution prescribed before surgery?

A. Take the medication with juice

B. Take the medication before going to bed

C. Avoid exposure to sunlight when taking the medication

D. Take propylthiouracil (PTU) after taking Lugol solution

Correct Answer: A. 
Take the medication with juice
 

The thyroid gland absorbs dietary iodine, found in many foods, combines it with the amino acid tyrosine, and converts it into thyroid hormones thyroxine (T4) and triiodothyronine (T3). Although iodine is necessary for synthesis of thyroid hormone in individuals with normal thyroid function, it inhibits synthesis and release of thyroid hormone in individuals with hyperthyroidism.

Lugol solution is a solution of potassium iodide and iodine that is given prior to a thyroidectomy. The client should be instructed to take 5-7 drops 3 times a day for 10 days before the surgery. In clients who are hyperthyroid, the iodine will inhibit synthesis of thyroid hormone and secretion into the circulation while decreasing the size and vascularity of the gland to reduce the risk of complications of surgery. The solution has a bitter taste and should be given with juice. Lugol solution is also used for treatment of thyroid storm and for short-term treatment of hyperthyroidism. It should not be taken after PTU, methimazole, or radioactive iodine.

Incorrect Answers:
B. Lugol solution drops are taken 3 times a day.

C. Photosensitivity does not occur with Lugol solution.

D. PTU, methimazole, or radioactive iodine should not be taken after Lugol solution.

Vital Concept:
Lugol solution, a potassium iodide-iodine solution, inhibits synthesis and release of thyroid hormone in individuals with hyperthyroidism. It is prescribed for individuals with hyperthyroidism for ten days prior to thyroidectomy, to decrease serum levels of thyroid hormone and reduce the size and vascularity of the thyroid gland. It is also used in conjunction with other medications to treat thyroid storm.

 
References:
Ignatavicius DD, et al. (2017). Medical-surgical Nursing: Patient-centered Collaborative Care. Philadelphia, PA: WB Saunders Co.

https://www.uptodate.com/contents/potassium-iodide-and-iodine-lugol-solution-drug-information

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