Chapter 58: Drugs for Thyroid Disorders

Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse?

excessive bruising

The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75 mcg tablets. How many tablets will the nurse administer?

2

The primary healthcare provider prescribes a thyroid replacement drug to a patient with hypothyroidism. How should the nurse monitor for return to a euthyroid state?

Analyze the patients serum thyroid-stimulating hormone levels

A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131?

Beta human chorionic gonadotropin (hCG) test

A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions?

I'll take this medication in the morning so as not to interfere with sleep

A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient indicates an understanding of the treatment's effects?

I'll tell my doctor if i have fatigue, hair loss, or cold intolerance

The endocrinologist prescribes radioactive iodine to an adult patient who has thyroid cancer. What is the reason for prescribing this drug to the patient?

It destroys cancerous or overactive thyroid tissue

The nurse is assessing an elderly patient who has been taking levothyroxine [Synthroid] for 6 months. The nurse finds that the patient has anxiety, tachycardia, and insomnia. What should the nurse interpret from these findings?

The patient is experiencing adverse effects of the thyroid drugs

While reviewing the history and the lab reports of an adult patient, the nurse finds that the patient has decreased metabolic rate, weight gain, and hair loss. What can the nurse interpret from these findings?

The patient may have myxedema

Which statement is the most important for a nurse to make to a patient who is taking methimazole [Tapazole]?

You need to notify your doctor if you have a sore throat and fever

During an assessment, a patient asks the nurse, "What should I do if I miss two or three doses of thyroid replacement drug in a row?" Which is the nurse's best response?

You should consult your primary healthcare provider

The patient newly diagnosed with hypothyroidism has been prescribed levothyroxine. The nurse should give the patient which instruction(s)? Select all that apply.

-Levothyroxine brands should not be changed, if possible -Levothyroxine can affect the metabolism of other medication -Levothyroxine can be given intravenously but is usually taken orally

The nurse is giving an intravenous injection of levothyroxine [Synthroid] to a child who has congenital hypothyroidism. The prescription reads: levothyroxine [Synthroid], 0.1 mg, intravenous, once a day for 3 days. The drug is available as a 200 mcg vial. What quantity of the drug should the nurse administer every day? Record your answer using one decimal place. ________ mL

2.5 mL

Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]?

Tachycardia

A patient diagnosed with thyroid cancer undergoes a thyroidectomy and is prescribed levothyroxine sodium [Synthroid]. What instructions should the nurse give the patient about taking this medication?

Take on an empty stomach

The nurse is teaching safe administration of medication to a patient who has been prescribed levothyroxine [Levoxyl]. Which statement should the nurse include in the teaching session?

Take this medicine on an empty stomach in the morning, at least 30-60 minutes before eating

The clinical instructor asks the nursing student about various drug interactions of thyroid drugs. Which statement by the nursing student indicates effective learning?

Thyroid drugs should not be taken to treat obesity

The patient reports that she had to switch pharmacies to save money. She noted that her thyroid pill looked different. The nurse anticipates that the healthcare provider will order which test?

Thyroid stimulating hormone (TSH)