Pharmacology Thyroid meds #4

Question

The home care nurse observes that the patient’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 patient 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.

Overview

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

Explanation

Constipation and fatigue are assessment findings for hypothyroidism. Since the client has 20 extra doses, then the client may have missed 20 days of treatment since the medication is usually prescribed once daily. Signs of hypothyroidism may be present as a result of so many missed doses. All of the other selections indicate hyperthyroidism (diarrhea, agitation, tachycardia, weight loss, exophthalmos, and tremors.

Learning Outcomes

Levothyroxine is synthetic thyroid hormone given to patients to treat hypothyroidism. Symptoms of hypothyroidism include constipation, fatigue, bradycardia, and weight gain. If a patient 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 patient 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” and symptoms will reflect a slow bowel (constipation), slow heart (bradycardia), slow energy (fatigue), and slow metabolism (weight gain).

Video Rationale