This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The ... (Read 31 times)

joesmith1212

  • Hero Member
  • *****
  • Posts: 549
on: Jul 23, 2018
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect the provider to:
 
  a. change the dose of levothyroxine to 6 mcg/kg/day.
  b. discontinue the drug if the child's physical and mental development is normal.
  c. increase the dose to accommodate the child's increased growth.
  d. stop the drug for 4 weeks and check the child's TSH level.

Question 2

An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do?
 
  a. Administer the medication as ordered.
  b. Contact the provider to discuss giving the levothyroxine IV.
  c. Request an order to give desiccated thyroid (Armour Thyroid).
  d. Suggest that the provider lower the dose.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

frankwu0507

  • Sr. Member
  • ****
  • Posts: 322
Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: A
In the treatment of cretinism, thyroid dosing decreases with age. For infants 6 to 12 months of age, the dose is 6 mcg/kg/day. At 1 year of age, the dose is reduced to 5 to 6 mcg/kg/day. For all children, treatment should continue for 3 years. It is incorrect to increase the dose with age. After 3 years of therapy, the patient undergoes a trial of 4 weeks without the drug, followed by assessment of the TSH and T4 levels, to determine whether the drug may be discontinued.

Answer to Question 2

ANS: D
In older adult patients, initial dosing of levothyroxine should start low and be increased gradually. A typical starting dose for an elderly patient is 25 to 50 mcg/day. It is not correct to administer the medication without questioning the provider. Unless the patient has signs of myxedema, there is no need to give the medication IV. Desiccated thyroid is no longer used except in patients who have been taking it long term.


joesmith1212

  • Member
  • Posts: 549
Reply 2 on: Jul 23, 2018
:D TYSM

peter

  • Member
  • Posts: 330
Reply 3 on: Yesterday
Gracias!

« previous next »
 

Did you know?

Drug abusers experience the following scenario: The pleasure given by their drug (or drugs) of choice is so strong that it is difficult to eradicate even after years of staying away from the substances involved. Certain triggers may cause a drug abuser to relapse. Research shows that long-term drug abuse results in significant changes in brain function that persist long after an individual stops using drugs. It is most important to realize that the same is true of not just illegal substances but alcohol and tobacco as well.

Did you know?

Methicillin-resistant Staphylococcus aureus or MRSA was discovered in 1961 in the United Kingdom. It if often referred to as a superbug. MRSA infections cause more deaths in the United States every year than AIDS.

Methicilli ...
Did you know?

Disorders that may affect pharmacodynamics include genetic mutations, malnutrition, thyrotoxicosis, myasthenia gravis, Parkinson's disease, and certain forms of insulin-resistant diabetes mellitus.

Did you know?

Though “Krazy Glue” or “Super Glue” has the ability to seal small wounds, it is not recommended for this purpose since it contains many substances that should not enter the body through the skin, and may be harmful.

Did you know?

There can actually be a 25-hour time difference between certain locations in the world. The International Date Line passes between the islands of Samoa and American Samoa. It is not a straight line, but "zig-zags" around various island chains. Therefore, Samoa and nearby islands have one date, while American Samoa and nearby islands are one day behind. Daylight saving time is used in some islands, but not in others—further shifting the hours out of sync with natural time.

20,000 year old Arctic ground squirrel mummy 20,000 year old Arctic ground squirrel mummy
Photograph of a child with a cochlear implant. This device sends electrical impulses directly to the Photograph of a child with a cochlear implant. This device sends electrical impulses directly to the
Child with bacterial meningitis in an opisthotonic position. Child with bacterial meningitis in an opisthotonic position.
Precious Child Precious Child
A 100-Year Flood Map of Montpelier, Vermont A 100-Year Flood Map of Montpelier, Vermont
The average weight gain between Thanksgiving and New Year's Day is about a pound The average weight gain between Thanksgiving and New Year's Day is about a pound
Video: Tuberculosis Testing

For a complete list of videos, visit our video library