Nokea
During ongoing assessment the nurse should observe a client taking levothyroxine for which of the following indicating a therapeutic response? Select all that apply.
- A. Weight loss
- B. Mild diuresis
- C. Increased appetite
- D. Increased mental activity
- E. Decreased pulse rate
Correct Answer: A,B,C,D
Rationale: Signs of therapeutic response to levothyroxine include weight loss; mild diuresis; increased appetite; increased pulse rate; decreased puffiness of face, hands, and feet; and client report of increased mental activity and increased sense of well-being.
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A nurse is caring for a client undergoing thyroid hormone replacement therapy. The nurse instructs the client to take the drug at which time?
- A. Before bedtime
- B. Just before dinner
- C. After lunch
- D. Before breakfast
Correct Answer: D
Rationale: The nurse should inform the client undergoing thyroid hormone replacement therapy to take the drug in the morning, preferably before breakfast. The nurse should not ask the client to take the drug before bedtime, just before dinner, or after lunch as that is not generally recommended by the health care provider.
A client with a heart condition controlled on which of the following drugs must be monitored closely by the nurse for worsening atrial fibrillation if levothyroxine is initiated to treat hypothyroidism? Select all that apply.
- A. Lisinopril (Prinivil)
- B. Digoxin (Lanoxin)
- C. Diltiazem (Cardizem)
- D. Metoprolol (Toprol)
- E. Warfarin (Coumadin)
Correct Answer: B,D
Rationale: A client with a heart condition controlled on digoxin (Lanoxin) and metoprolol (Toprol) must be monitored closely by the nurse for worsening atrial fibrillation if levothyroxine is initiated to treat hypothyroidism because levothyroxine can decrease the effectiveness of digoxin and beta blockers (metoprolol).
A nurse is caring for a client with chronic lymphocytic thyroiditis. The physician has prescribed liothyronine to the client. The nurse understands that the drug is administered cautiously to clients with which of the following?
- A. Upper respiratory tract infection
- B. Diabetes
- C. Elevated body temperature
- D. Cardiac disease
Correct Answer: D
Rationale: The nurse should be cautious about existing conditions such as cardiac disease and also cautious about factating clients before administering liothyronine to clients with chronic lymphocytic thyroiditis. The nurse need not be cautious about administering liothyronine to clients with an upper respiratory tract infection, diabetes, or elevated body temperature. The nurse should be cautious about clients contracting an upper respiratory tract infection on administrating antithyroid drugs. A client with diabetes may experience an increase in diabetes while undergoing thyroid hormone replacement therapy. The nurse should observe for elevated body temperature while managing the needs of a client administered thyroid hormones.
A nurse is preparing to administer the thyroid hormone replacement drug levothyroxine to a client. The nurse understands which of the following about this drug? Select all that apply.
- A. Equivalent to all other thyroid hormone replacement drugs
- B. More uniform potency than other thyroid hormone replacement drugs
- C. Twice-daily dosing necessary
- D. Relatively inexpensive
- E. Less frequent lab monitoring required
Correct Answer: B,D
Rationale: The following is true of the thyroid hormone replacement drug levothyroxine: it is relatively inexpensive, requires once-daily dosing, and has a more uniform potency than do other thyroid hormone replacement drugs.
When teaching a client about his prescribed levothyroxine therapy, the nurse determines that the teaching was successful when the client states that he will contact his primary health care provider if which of the following occur? Select all that apply.
- A. Constipation
- B. Palpitations
- C. Excessive diaphoresis
- D. Significant weight changes
- E. Chest pain
Correct Answer: B,C,D,E
Rationale: The client taking levothyroxine should contact his primary health care provider if any of the following occur: headache, nervousness, palpitations, diarrhea, excessive diaphoresis, heat intolerance, chest pain, increased pulse rate, significant weight changes, or any unusual physical change or event.