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9 Cards in this Set
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The patient reports fatigue, weight loss, and dry skin. The primary care NP orders thyroid function test. The patient's thyroid stimulating hormone TSH is 40. And T4 is 0.1. The NP should refer the patient to an endocrinologist and prescribe |
Levothyroxine. This patient has hypothyroidism and should be treated with Levothyroxine. Methimazole is a thyroid suppressant. Leo thyronine is synthetic T3. Propylthiouracil is a thyroid suppressant |
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A patient who has hypothyroidism has been taking Levothyroxine 50 micrograms daily for 2 weeks. The patient reports continued fatigue. The primary NP should |
Check the TSH level in one week. Full therapeutic Effectiveness may not be acheived for 3 to 6 weeks. Measuring the TSH level is indicated to evaluate drug Effectiveness. The dose should not be increased without first evaluating the patient's TSH level |
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A NP orders thyroid function tests. the patient's TSH is 1.2 and the T4 is 1.7 the NP should |
Tell the patient that the results most likely indicate hypothyroidism. Primary hypothyroidism is the most common form of hyperthyroidism. Use of certain drugs such as lithium and diseases such as Hashimoto's thyroiditis can cause hypothyroidism but are less likely. The patient does not have signs of hyperthyroidism. |
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An 80 year old female with a history of angina has increased TSH and decreased T4. The primary care NP should prescribe_____ mcg of______ |
25 micrograms of Levothyroxine. Elderly individuals may experience exacerbations of cardiovascular disease and angina with thyroid hormone replacement. It is advisable to start low at 25 micrograms and work up as tolerated. Liothyronine is a synthetic T3 |
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A child who has congenital hypothyroidism takes levothyroxine 75 micrograms daily. The child weighs 15 kg. The NP sees the child for a three-year-old check up. The NP should consult with a pediatric endocrinologist to discuss |
Decreasing the dose to 30 micrograms per day. In congenital hypothyroidism, therapy maybe stop for 2 to 8 weeks after the patient reaches 3 years of age if TSH levels remain normal thyroid supplementation can be discontinued permanently |
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A primary NP prescribed levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication the NP should |
Tell the patient that changing brands of the medication should be avoided. Patients should not change brands of medication. There is potential variability in the bioequivalence between manufacturers. The medication should be taken at approximately the same time each day before breakfast on empty stomach. Patients should be instructed to contact provider if signs of toxicosis are present thyroid replacement medications are usually given for life |
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A patient has been taking Levothyroxine 100 micrograms daily for several months the patient comes to the clinic with complaints of insomnia and irritability the primary care NP notes a heart rate of 92 per minute. The NP should |
Order TSH and T4 levels and decrease the dose to 75 micrograms per day |
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A 75 year old patient who has cardiovascular disease reports insomnia and vomiting for several weeks the NP orders thyroid function test. The test showed TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and Order |
Methimazole. Patients with hyperthyroidism or Graves disease will require radioactive iodine. Elderly patients and patients with cardiovascular disease should be pre-treated with an anti thyroid medication such as methimazole. Thyrotropin is used to diagnose thyroid cancer. Levothyroxine is used to treat hypothyroidism. Propylthiouracil is also a thyroid suppressant, but methimazole is preferred |
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A patient with Graves disease is taking methimazole. After 6 months of therapy the primary care NP notes normal T3 and T4 and elevated TSH. The NP should |
Decrease the dose of the medication. Once clinical levels of thyrotoxicosis have been resolved, elevated TSH indicates a need to reduce the dosage. A CBC with differential is performed at the beginning of treatment and when signs of infection are present. Liver function tests may be monitored periodically but are not indicated by the current lab results. Levothyroxine is not indicated. |
