Chapter 31 Evolve Questions
A patient receiving propylthiouracil (PTU) asks the nurse, "How does this medication relieve symptoms?" What is the nurse's best response?
" PTU inhibits the formation of PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal." PTU is an antithyroid medication used to treat hyperthyroidism. It works by inhibiting the synthesis of new thyroid hormone. It does not inactivate present hormone.
Which statement by the patient indicates an understanding of discharge instructions given by the nurse about the newly prescribed medication levothyroxine (Synthroid)? A. "I will take a double dose to make up for the missed one." B. "I can expect improvement of my symptoms within 1 week." C. "I will stop the medication immediately if I feel pain or weakness in my muscles." D. "I will take this medication in the morning so it does not affect my sleep at night."
"I will take this medication in the morning so it does not affect my sleep at night." Levothyroxine increases basal metabolic rate and thus may cause insomnia. Patients shouldn't double the dose or stop taking the medication abruptly. It may take up to 4 weeks for a therapeutic response to occur.
Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy? A. "I will need to take this drug on a daily basis for at least 1 year." B. "This drug will help decrease my cold intolerance and weight gain." C. "This drug will be taken up by the thyroid gland and destroy thyroid tissue." Correct D. "I will isolate myself from my family for 1 week so there is no risk of radiation exposure."
"This drug will be taken by the thyroid gland and destroy thyroid tissue." Radioactive iodine is an antithyroid medication that is administered orally. It concentrates in the thyroid gland, where its radioactivity destroys thyroid tissue.
The nurse has a prescription to The nurse has a prescription to change the patient's levothyroxine (Synthroid) dosage from oral to intravenous (IV). The patient takes 150 mcg/day by mouth, and the prescription is to administer 50% of the oral dose by the IV route. How much will the nurse administer per day?
75 mcg 150 mcg/day (0.50) = 75 mcg
When assessing for potential serious adverse effects to propylthiouracil (PTU), the nurse will monitor which laboratory test?
Complete Blood Count (CBC) With antithyroid medications, the nurse should monitor for possible serious adverse reactions such as agranulocytosis, leukopenia, and thrombocytopenia. An abnormal CBC result would indicate bone marrow dysfunction.
For a patient taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently, the nurse would closely monitor for which possible serious adverse effect?
Increased bruising Levothyroxine can compete with protein-binding sites of warfarin, allowing more warfarin to be unbound or free, thus increasing effects of warfarin and risk of bleeding. Bleeding commonly presents as bruising.
The nurse would suspect a patient is taking too much levothyroxine (Synthroid) when the patient exhibits which adverse effect?
Irritability Irritability is a symptom of hyperthyroidism and may indicate toxicity of the medication. The other choices are signs of hypothyroidism.
The nurse is reviewing the adverse effects of antithyroid medications for a patient prescribed propylthiouracil (PTU). What potential serious adverse effects should the nurse discuss with the patient during discharge teaching? (Select all that apply.) A. Joint pain B. Liver toxicity C. Kidney damage D. Increased urination E. Bone marrow toxicity
Joint Pain, Liver Toxicity, and Bone Marrow Toxicity The most damaging or serious adverse effects of the antithyroid medications are liver and bone marrow toxicity. Myalgias and arthralgias (joint pain) may also occur with PTU.
The nurse is teaching a patient taking an antithyroid medication to avoid food items high in iodine. Which food item should the nurse instruct the patient to avoid?
Seafood Seafood contains high amounts of iodine. The other choices do not.
