Author Question: A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse ... (Read 87 times)

Anajune7 · **on:** Jul 23, 2018

A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose.

a. reducing; levothyroxine
b. reducing; warfarin
c. increasing; levothyroxine
d. increasing; warfarin

Question 2

A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2 F.

The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)

ririgirl15 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Levothyroxine accelerates the degradation of vitamin Kdependent clotting factors, which enhances the effects of warfarin. Patients taking warfarin who start taking levothyroxine may need to have their warfarin dose reduced. It is not correct to increase or decrease the levothyroxine dose or to increase the warfarin dose.

Answer to Question 2

ANS: C
Intravenous administration of levothyroxine is used for myxedema coma. This patient is showing signs of severe hypothyroidism, or myxedema. A beta blocker is useful in patients who show signs of hyperthyroidism to minimize cardiac effects. Because the half-life of oral levothyroxine is so long, increasing the PO dose will not provide immediate relief of this patient's symptoms. Methimazole is used to treat hyperthyroidism.