Medical Surgical Thyroid #12

Question

The home care nurse observes that the client’s supply of levothyroxine has 20 extra doses in the medication bottle. What assessment finding would be most consistent with underuse of the medication levothyroxine?

Answers

  1. Constipation and fatigue
    • Rationale:

      This answer is correct because symptoms of hypothyroidism include constipation, fatigue, bradycardia, and weight gain. If a client does not take their levothyroxine, thyroid hormone levels will decrease and hypothyroidism symptoms will return.

  2. Diarrhea and agitation
    • Rationale:

      This answer is not correct because diarrhea and agitation are symptoms associated with hyperthyroidism and excessive amounts of thyroid hormone. If excessive levothyroxine levels occur, hyperthyroidism symptoms will be evident, including diarrhea, agitation, tachycardia, tremor, exophthalmos, and weight loss.

  3. Tachycardia and weight loss
    • Rationale:

      This answer is not correct because tachycardia and weight loss are symptoms associated with hyperthyroidism and excessive amounts of thyroid hormone. If excessive levothyroxine levels occur, hyperthyroidism symptoms will be evident, including diarrhea, agitation, tachycardia, tremor, exophthalmos, and weight loss.

  4. Exophthalmos and fine tremors
    • Rationale:

      This answer is not correct because exophthalmos and fine tremors are symptoms associated with hyperthyroidism and excessive amounts of thyroid hormone. If excessive levothyroxine levels occur, hyperthyroidism symptoms will be evident, including diarrhea, agitation, tachycardia, tremor, exophthalmos, and weight loss.

  5. Feeling cold and depressed
    • Rationale:

      This answer is correct because the thyroid slows down metabolism, causing a decrease in your body temperature. In hypothyroidism, the thyroid does not make enough thyroid hormone, which is linked to serotonin and norepinephrine which are hormones that function as neurotransmitters that regulate emotions. A decrease in these caused by hypothyroidism, or not taking levothyroxine can cause depression.

Overview

Levothyroxine is given to increase thyroid hormone in the body. If the client does not take the thyroid hormone, hypothyroid symptoms will appear, such as constipation and fatigue.

Explanation

Learning Outcomes

Levothyroxine is synthetic thyroid hormone given to clients to treat hypothyroidism. Symptoms of hypothyroidism include constipation, fatigue, bradycardia, and weight gain. If a client does not take their levothyroxine, thyroid hormone levels will decrease and hypothyroidism symptoms will return. If excessive levothyroxine levels occur related to excessive levothyroxine intake, hyperthyroidism symptoms will be evident, including diarrhea, agitation, tachycardia, tremor, exophthalmos, and weight loss. The client should be educated to take medication as ordered and report symptoms of hyperthyroidism or hypothyroidism so medication levels can be adjusted. Periodic blood tests are ordered to evaluate current blood levels and can assist in prescribing and adjustment of levothyroxine.

Test Taking Tip

Remember that hypothyroidism symptoms are related to slow metabolism associated with decreasing levels of thyroid hormones. Remember, “hypo or slow” symptoms will reflect a slow bowel (constipation), slow heart (bradycardia), slow energy (fatigue), and slow metabolism (weight gain).

Video Rationale