The nurse is caring for a patient newly diagnosed with hypothyroidism who has a new prescription for levothyroxine 50 mcg orally.
Which interventions will the nurse include in the plan of care? Select All That Apply.

Administer the medication in the morning with breakfast.

Monitor for chest pain or symptoms of angina.

Monitor prothrombin time for patients taking warfarin.

Stop the medication if patient has arrhythmias.

Decrease the dose of any sedative agents.

Answer and Explanation

Correct Answer : B,C,E

Choice A rationale

Levothyroxine should be taken on an empty stomach, typically 30-60 minutes before breakfast, to ensure proper absorption. Taking it with food can interfere with its effectiveness.

Choice B rationale

Monitoring for chest pain or symptoms of angina is crucial as levothyroxine can increase the heart rate and potentially exacerbate pre-existing heart conditions, especially in elderly patients.

Choice C rationale

Monitoring prothrombin time is important for patients taking warfarin because levothyroxine can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.

Choice D rationale

Stopping levothyroxine abruptly can cause severe hypothyroid symptoms, so it should not be discontinued without consulting a healthcare provider.

Choice E rationale

Hypothyroidism patients are often more sensitive to sedatives, so reducing the dose of any sedative agents can prevent excessive sedation and other adverse effects. .

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Correct Answer is C

Explanation

Choice A rationale

Dysmenorrhea, or painful menstrual cramps, is not a common side effect of propylthiouracil (PTU). PTU is used to manage hyperthyroidism, and it primarily affects the thyroid gland and related metabolic processes. Dysmenorrhea is typically related to reproductive system disorders and hormonal changes, rather than the medication for thyroid conditions.

Choice B rationale

Constipation is also not a typical symptom associated with propylthiouracil (PTU). PTU's effects are focused on thyroid hormone production, and constipation is more commonly related to other factors such as diet, hydration, and gastrointestinal conditions. Reporting constipation would not be as relevant in the context of PTU therapy.

Choice C rationale

Sore throat is a significant symptom to report as it can indicate agranulocytosis, a rare but severe side effect of propylthiouracil (PTU). Agranulocytosis is a condition where the body has a dangerously low number of white blood cells, which compromises the immune system, making infections more likely and harder to fight off. Early detection and intervention are crucial to prevent serious complications.

Choice D rationale

Increased urine output is not typically associated with propylthiouracil (PTU). While changes in metabolism can occur, increased urine output is more often related to other conditions such as diabetes mellitus or diuretic use. Reporting this symptom would not directly relate to PTU therapy.

A. The patient will have one formed bowel movement by the end of the shift. B. The patient's skin will be free of petechiae and purpura by discharge. C. The patient will tolerate meals without reports of nausea by the end of the day. D. The patient will be free from infection by discharge.

Correct Answer is D

Explanation

Choice A rationale

Filgrastim (G-CSF) is used to stimulate the production of white blood cells to decrease the risk of infection. A formed bowel movement is unrelated to the specific outcomes of this medication.

Choice B rationale

While filgrastim can improve overall blood cell counts, its primary goal is to enhance neutrophil counts, rather than addressing skin petechiae or purpura, which may be related to platelet levels.

Choice C rationale

Filgrastim does not target gastrointestinal symptoms such as nausea. Instead, it is aimed at restoring neutrophil levels to reduce infection risk.

Choice D rationale

Filgrastim is specifically designed to increase neutrophil counts, thus helping the patient to be free from infections by discharge, which is a SMART goal.

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The nurse is caring for a patient newly diagnosed with hypothyroidism who has a new prescription for levothyroxine 50 mcg orally.Which interventions will the nurse include in the plan of care? Select All That Apply.

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The nurse is caring for a patient newly diagnosed with hypothyroidism who has a new prescription for levothyroxine 50 mcg orally.
Which interventions will the nurse include in the plan of care? Select All That Apply.