A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?

A. They are more prone to hyperthermia and may require cooling measures: Hypothyroidism typically leads to hypothermia (lower body temperature) rather than hyperthermia. Clients with hypothyroidism are more likely to experience difficulty maintaining normal body temperature.
B. Their levothyroxine should be held for 3 days prior to and after the surgery: Levothyroxine should not be held before or after surgery without specific guidance from the healthcare provider. Maintaining consistent thyroid hormone levels is crucial for clients with hypothyroidism.
C. They are at risk of developing tachycardia and should be given propranolol: Hypothyroidism is more commonly associated with bradycardia (slow heart rate) rather than tachycardia (fast heart rate). Propranolol is used to manage symptoms of hyperthyroidism, not hypothyroidism.
D. They are more sensitive to the effects of opioids and may require lower doses: Clients with hypothyroidism often have a reduced metabolic rate, which can increase their sensitivity to medications, including opioids. Therefore, they may require lower doses of opioids to avoid adverse effects.

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.