- Medical History: Thyroidectomy 6 months ago, seasonal allergies
Current Medications: Levothyroxine
Current Visit: Client presents to clinic with diarrhea, excessive sweating, and muscle pain; reports occasional palpitations started about 1 week ago.
Client Profile
Nursing Notes
Name: Christopher Brown
Age: 36 years
Provider. M. Jensen, M.D.
Allergies: Shellfish
Code Status: Full code
Weight: 88 ka (194 lb)
Review the electronic health record. Which clinical finding(s) indicate levothyroxine toxicity? Select all that apply.
Occasional palpitations
Seasonal allergies
Muscle pain
Excessive sweating
Diarrhea
Correct Answer : A,C,D,E
A. Occasional palpitations: Palpitations are a common sign of levothyroxine toxicity because excessive thyroid hormone increases cardiac output and sympathetic activity, leading to an elevated heart rate and irregular heart rhythms, which can be dangerous if untreated.
B. Seasonal allergies: Seasonal allergies are unrelated to levothyroxine therapy. They are a chronic, immune-mediated response to environmental allergens and do not indicate thyroid hormone toxicity.
C. Muscle pain: Muscle aches or weakness can occur with levothyroxine overdose due to hypermetabolism, increased protein catabolism, and overstimulation of muscle activity, making this a relevant symptom of toxicity.
D. Excessive sweating: Hyperthyroid-like symptoms, including diaphoresis, occur with levothyroxine toxicity as a result of increased basal metabolic rate and overstimulation of sympathetic nervous system activity.
E. Diarrhea: Increased gastrointestinal motility is a hallmark of levothyroxine overdose. Clients may experience frequent loose stools or diarrhea due to the hypermetabolic state induced by excess thyroid hormone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Pharmacy location: The location of the pharmacy may affect access to medication but does not physiologically influence how a drug works in the body. It does not alter absorption, metabolism, distribution, or excretion of the medication.
B. Client's financial status: Financial status may impact adherence if the client cannot afford the medication, but it does not directly affect the pharmacologic response once the drug is administered.
C. Client's diet: Diet can significantly influence drug response. Foods may interact with drug absorption (e.g., calcium with tetracyclines), metabolism (e.g., grapefruit juice inhibiting CYP3A4), or excretion, thereby altering the effectiveness and safety of the medication.
D. Type of insurance: Insurance affects access to medications and cost coverage but does not change the pharmacokinetics or pharmacodynamics of a drug, so it does not directly affect therapeutic response.
Correct Answer is A
Explanation
A. Peak effect: The peak effect of a drug is the point at which it produces its maximum therapeutic response in the body. It reflects the highest concentration at the site of action and helps guide optimal dosing schedules to achieve effective treatment without causing toxicity.
B. Steady state: Steady state refers to the point at which the drug’s intake and elimination are balanced, resulting in consistent plasma levels. It does not indicate the maximum effect but ensures ongoing therapeutic levels over time.
C. Duration of action: Duration of action is the total time a drug produces a therapeutic effect, not the intensity or maximum response. It helps determine how often a medication should be administered to maintain efficacy.
D. Onset of action: Onset of action is the time it takes for a drug to begin producing a noticeable effect after administration. It indicates how quickly a drug works, not the magnitude of its effect.
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