EAQ Ch 36 Drugs to Treat Thyroid Disease

A patient prescribed metformin (Glucophage) reports muscle pain, weakness, and difficulty breathing. The patient's blood pressure is found to be 78 mm Hg systolic and 60 mm Hg diastolic. Which medication might have led to the patient's condition?

Rantidine

The healthcare provider prescribes a synthetic form of the natural thyroid hormone triiodothyronine (T 3) to a patient. Which medication does the nurse find in the patient's prescription?

Liothrytonine is the synthetic form of T3

A nurse is teaching a patient diagnosed with hypothyroidism who is prescribed levothyroxine about precautions to be taken to prevent drug interactions. Which statement by the patient indicates a need for further teaching?

If I concurrently take levothyroxine and digoxin, I may need to decrease the dosage of digoxin

After assessing a patient, the healthcare provider concludes that prompt action is needed to control the patient's hypothyroid state. Which medication does the nurse anticipate will be prescribed

Liothyronine (Triostat)

Which medication for treatment of hypothyroidism is a synthetic mixture of levothyroxine (Synthroid) and liothyronine (Cytomel)?

Liotrix (Thyrolar)

Which instruction by the nurse is appropriate for a patient who is prescribed propylthiouracil for the treatment of a thyroid disorder?

" Do not stop taking the medication w/o 1st informing your provider even if adverse effects develop

When assessing a patient suspected of having a thyroid disorder, which question would help the nurse assess the patient's gastrointestinal system?

"Did you lose or gain weight over the past 3 months?"

Which patients are most likely to be prescribed radioactive iodine (iodine-131)? Select all that apply.

* A 60 year old hyperthyroid patient * A hyperthyroid pt with heart disease *A hyperthyroid pt who has already undergone a thyroidectomy

A patient with a thyroid disorder is scheduled for a thyroidectomy. Which nursing interventions are appropriate while preparing the patient for surgery? Select all that apply.

* Ordering a bedside tracheostomy set * Keeping calcium gluconate and IV administration supplies ready

Which drugs block the synthesis of triiodothyronine (T 3) and thyroxine (T 4) in the thyroid gland? Select all that apply.

* Propylthioracil * Methimazole (Tapazole)

Which body functions are regulated by the thyroid hormones? Select all that apply.

* Reproduction * Lipid metabolism * Growth ad maturation

Which body functions are regulated by the thyroid hormones? Select all that apply.

* Reproduction * Lipid metabolism * Growth and maturation

Which conditions may lead to hyperactivity of the thyroid gland.

* Thyrioditis * Graves' disease * Thyroid carcinoma

A patient with a history of polyuria, polyphagia, and polydipsia was prescribed insulin (NovoLog) treatment. During a follow-up visit, the patient reports headache, sweating, cold and clammy skin, and increased hunger. Which treatments may benefit the patient? Select all that apply.

* drinking 2-4 oz of fruit juice * administering glucose tablets (Dex4 Glucose)

What does the thyroid stimulating hormone do?

* it is secreted by the anterior pituitary gland * it is stimulates the gland that releases T3 and T4

Which statements about thyroid-stimulating hormone (TSH) are correct? Select all that apply.

* it regulates general body metabolism * it is secreted by the anterior pituitary gland * It stimulates the gland that releases T3 and T4

Which thyroid hormone replacements are used to treat hypothyroidism? Select all that apply.

* liotrix (thyrolar) * Liothyronine (Cytomel) * Levothyroxine (Synthroid)

Which symptoms should the nurse assess for in a patient suspected of having hypothyroidism? Select all that apply.

* weight gain * constipation * cold intolerance

Which medications does the nurse identify as antithyroid agents? Select all that apply.

*Propylthiouracil * Methimazole (Tapazole) * Radioactive iodine (iodine-131)

Which medication used to treat thyroid diseases may cause lymph node enlargement?

Methimazole

Arrange in order the events that occur when a nurse administers radioactive iodine (iodine-131) to a patient with hyperthyroidism

1. The nurse adds the radioactive iodine to water and allows the pt to drink the mixture 2. Radioactive iodine (iodine-131) is absorbed into the thyroid gland in high concentrations. 3. the radioactive isotope is liberated 4. the hyperactive thyroid tissue is destroyed

Which medication used to treat thyroid diseases may cause hepatotoxicity?

Methimazole (Tapazole)

A patient is receiving iodine-131 ( 131I) therapy. After administration of the drug, how much time must pass before the benefits of therapy will be fully assessed?

3 to 6 months

Term uses to refer to the condition where a child is born without a thyroid gland

Cretinism

Which medication when taken with linezolid can cause tachycardia and hypertension?

Dopamine (intropin)

Which patient condition does the nurse infer from a 45-year-old patient's laboratory reports that show low serum levels of circulating triiodothyronine (T 3) and thyroxine (T 4) hormones?

Myxedema

A pt with which condition may develop hyperthyroidism?

Pituitary gland exposure

When caring for a patient who is scheduled for a subtotal thyroidectomy, which short-term treatment does the nurse anticipate will be prescribed to the patient before the surgery?

Proplthiouracil

For which adverse effect does the nurse monitor in a patient taking propylthiouracil (Propacil)?

Purpuric, macular rash

Which finding in a patient who is taking lithium (Eskalith) and is also receiving iodine-131 ( 131I) therapy would concern the nurse?

Symptoms of hypothyroidism and bipolar disorder

Four patients with thyroid disorders are prescribed different types of medications. Which patient's laboratory tests would show consistent results?

The laboratory reports of patient B, who is prescribed liotrix (Thyrolar), may show consistent test results because liotrix (Thyrolar) is a synthetic mixture of levothyroxine (T 4) and liothyronine (replacement hormone for T 3), which has a standardized 4:1 ratio of T 4 and T 3. Liothyronine (Cytomel) contains only T 3 hormone, levothyroxine (Synthroid) contains only T 4 hormone, and thyroid USP (Westhroid) contains an unpredictable T 4 to T 3 ratio. Therefore the laboratory reports of patients A, C, and D may not show consistent test results

Which medication is derived from pig, beef, and sheep thyroid glands?

Thyroid USP (Armour Thyroid)

Which hormone is secreted by the anterior pituitary gland?

Thyroid-stimulating hormone (TSH)

Which hormone is secreted by the hypothalamus?

Thyrotropin-releasing hormone (TRH)

Which finding in a patient who is taking lithium (Eskalith) and is also receiving iodine-131 ( 131I) therapy would concern the nurse?

symptoms of hypothyroidism and bipolar disorder

Which instructions from the healthcare provider regarding administration of penicillin would be beneficial for the patient? Select all that apply.

decrease the intake of potassium supplements limit the intake of antacids during the therapy

For which patient would the nurse question the use of iodine-131 ( 131I) for treatment of hyperthyroidism?

female pt of childbearing age. (iodine-131 is radioactive and hence presents a risk to fertility and not suitable for a woman of childbearing age)

The nurse will monitor a patient prescribed liotrix (Thyrolar) for treatment of hypothyroidism for which adverse effect?

heat intolerance

Which condition is caused by inadequate production of thyroid hormones?

hypothyriodism

Which medication is available as an injection

liothyronine (Cytomel)

How is propylthiouracil different from methimazole?

propylthiouracil causes maculopapular rash

Four patients are prescribed medications for the treatment of thyroid diseases. Which patient is most likely to develop salivary gland enlargement?

pt A Rationale:Propylthiouracil may cause salivary gland enlargement in patient C. Methimazole may cause nephrotoxicity in patient A. Radioactive iodine (iodine-131) may cause radioactive thyroiditis in patient B. Overdose of levothyroxine may cause hyperthyroidism in patient D.

Which statement about the difference between radioactive iodine (iodine-131) and methimazole (Tapazole) is correct?

radioactive iodine may cause hypothyroidism whereas methimazole may cause bone marrow suppression