Class 10

Question 1

Levothyroxine is used for

Answer 1

• Mild to severe hypothyroidism
• Used diagnostically in suppression test to differentiate suspected hyperthyroidism from euthyroidism (normal thyroid function)

Question 2

Adverse effects for Levothyroxine

Answer 2

• Overdose – hyperthyroidism – thyroid crisis.
• Thyroid crisis including angina, tachycardia, palpitations, hypertension, cardiac dysrhythmia, nausea and vomiting, diarrhea cramping, insomnia, tremors, headache, nervousness, irritability, weight loss, and fever/

Question 3

Levothyroxine nursing concerns

Answer 3

• Baseline vital signs (VS), body weight and fluid intake and output
• Obtain ECG and lab studies including T3, T4 and TSH
• Monitor pulse rate before each dose and don’t administer if heart rate greater than 100,
• Assess periodically for symptoms of hypothyroidism and hyperthyroidism
• Instruct patient take drug at the same time, preferably before breakfast
• Avoid foods with inhibition on thyroid hormones including strawberries, peaches, pears, cabbage, turnips, spinach, kale, cauliflower, radishes, and peas)
• Monitor blood glucose levels if patient is diabetic

Question 4

Medication for Hyperthyroidism

Answer 4

Propylthiouracil (Propyl-Thyracil, PTU)

Question 5

MOA of Propylthiouracil (Propyl-Thyracil, PTU)

Answer 5

• Inhibit thyroid hormone synthesis

- Suppress peripheral conversion of T4 to T3

Question 6

Symptoms of hyperthyroidism

Answer 6

Palpitations
Heat intolerance
Nervousness & Insomnia
Breathlessness 
Increased bowel movements 
Light or absent menstrual periods 
Fast heart rate 
Trembling hands 
Weight loss 
Muscle weakness 
Warm moist skin 
Hair loss 
Staring gaze (exophthalmos)

Question 7

Symptoms of hypothyroidism

Answer 7

Fatigue
Weakness
Weight gain or increased difficulty losing weight
Coarse, dry hair 
Dry, rough pale skin hair loss
Cold intolerance 
Muscle cramps and frequent muscle aches
Constipation 
Depression, irritability, memory loss 
Abnormal menstrual cycles 
Decreased libido