The nurse is caring for a patient who was diagnosed 2 days ago ...

[hubes95]

The nurse is caring for a patient who was diagnosed 2 days ago with hypothyroidism and has not yet been started on a drug regimen.
 
  Which of the following laboratory findings would the nurse most likely anticipate being consistent with a patient with hypothyroidism?
  a. Low serum T4 and elevated TSH
  b. High serum T4 and high TSH
  c. Low serum T4 and low TSH
  d. High serum T4 and low TSH

Question 2

A nurse is providing education for a patient recently started on levothyroxine (Levothroid).
 
  To evaluate the patient's knowledge of the drug-drug interactions explained in the patient's educational session, the nurse asks the patient which drugs should not be taken concurrently with levothyroxine. Which statement made by the patient best demonstrates the need for further teaching?
  a. I should avoid taking iron supplements.
  b. I should take only Maalox and Mylanta for indigestion.
  c. I should anticipate an increase in the dose of levothyroxine if I start taking sertraline (Zoloft) again.
  d. I should anticipate a decrease in my dose of warfarin (Coumadin).

[huda]

Answer to Question 1

ANS: A
Lab findings consistent with hypothyroidism are a T4 level under 4.5 mcg/dL and a TSH level above 6 microunits/mL. T4 would have to be low and TSH would have to be high as a result of the hypothyroidism.
With hypothyroidism, the T4 is low and the TSH is high.

Answer to Question 2

ANS: B
The statement that only Maalox and Mylanta should be taken for indigestion demonstrates a need for further teaching, because these medications are contraindicated with levothyroxine.
The patient should avoid taking iron supplements; no further teaching is necessary.
The interaction of sertraline and levothyroxine results in accelerated metabolism of levothyroxine and would require an increase in the dose of levothyroxine. Levothyroxine accelerates the degradation of warfarin and enhances its effects, therefore the dose may need to be reduced.

[hubes95]

Excellent

[bigcheese9]

TYSM