Evaluation of an adult client reveals oversecretion of growth hormone. May increase to 600 mg/day in absence of severe adverse drug reaction and severe nonleukemia related neutropenia or thrombocytopenia as follows. Last updated on Aug 17, 2020. [Ref], Frequency not reported: Palpitations, tachycardia, hypertension, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest[Ref], Frequency not reported: Changes in symptom presentation for diabetes and adrenal cortical insufficiency[Ref], Frequency not reported: Headache, hyperactivity, insomnia, seizures, pseudotumor cerebri (children)[Ref], Frequency not reported: Hair loss, flushing, urticaria, pruritus, skin rash, angioedema, excessive sweating[Ref], Frequency not reported: Tremors, muscle weakness, muscle cramps, increased risk of osteoporosis, slipped capital femoral epiphysis (children)[Ref]. The more commonly reported adverse events have included those of hyperthyroidism due to therapeutic overdose including arrhythmias, myocardial infarction, dyspnea, muscle spasm, headache, nervousness, irritability, insomnia, tremors, muscle weakness, increased appetite, weight loss, diarrhea, heat intolerance, menstrual irregularities, and skin rash. ... to decrease symptoms of hyperthyroidism in preparation for a thyroidectomy (removal of the thyroid gland) or radioactive iodine therapy. A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. The experimental vaccine and placebo were both manufactured by Sinovac Research & Development Co., Ltd. Silent: A painless, possibly enlarged thyroid, likely from an autoimmune condition. The nurse should state that the physician probably will order daily supplements of calcium and: During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should include which statement? 1- Tetany 2- Hemorrhage ... 2- Dyspnea 3- Weight loss 4- Hair loss. What symptoms does the nurse recognize as most significant for a patient with this disorder? What should the nurse do? A client is returned to his room after a subtotal thyroidectomy. tra´cheae ) the air passage extending from the throat and larynx to the main bronchi; it is about 1.5 cm (0.6 in) wide and 10 cm (4 in) long and is reinforced at the front and sides by a series of C-shaped rings of cartilage that keep the passage uniformly open. After thyroidectomy, patients are given thyroid replacement therapy with T4 (Synthroid) or triiodothyronine (T3, Cytomel) ... Local extension into the aerodigestive tract or surrounding tissues may cause dysphagia, dyspnea, or symptoms of pressure in the neck. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? The nurse auscultates a bruit over the thyroid glands. Along with its needed effects, levothyroxine (the active ingredient contained in Euthyrox) may cause some unwanted effects. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. A client has suffered from several autoimmune disorders over the last 25 years, and lately has developed a new set of symptoms. One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is: A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. Active surveillance [14] A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. Petersen K, Bengtason C, Lapidus L, et al "Morbidity, mortality, and quality of life for patients treated with levothyroxine." Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism? What can the nurse educate the patient regarding these symptoms? After the first trimester of pregnancy, ... dyspnea or hemoptysis (see WARNINGS and ADVERSE REACTIONS). Leese GP, Jung RT, Guthrie C, Waugh N, Browning MC "Morbidity in patients on L-thyroxine: a comparison of those with a normal TSH to those with a suppressed TSH." The nurse interprets this as which of the following? A client with a history of chronic hyperparathyroidism admits to being noncompliant. To ensure the best experience, please update your browser. O 0, 5. Disease progression (at any time) Failure to achieve a satisfactory hematologic response after at least 3 months of treatment A client is being evaluated for hypothyroidism. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse should anticipate that this patient may require the IV administration of: Trousseau's sign is elicited by which of the following? Sheppard MC, Holder R, Franklyn JA "Levothyroxine treatment and occurrence of fracture of the hip." Pharmaceutical Society of Australia "APPGuide online. The client's healthcare provider suspects Addison's disease. A nurse is caring for a client with Cushing's syndrome. Higher rates of femur fractures have been found in males (p=0.008) prescribed long-term thyroid hormone therapy as compared to controls in a case-control analysis of 23,183 patients, from the United Kingdom General Practice Research Database, prescribed thyroid hormone. A nurse is teaching a client with adrenal insufficiency about corticosteroids. In a client with Cushing's syndrome, the nurse expects to find: The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions? "Product Information. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height. Clin Endocrinol (Oxf) 37 (1992): 500-3. Cardiac function was evaluated in 20 patients requiring TSH suppression for either thyroid goiter or following thyroidectomy and radioactive iodine therapy for thyroid cancer and in 20 age and sex-matched controls. ([2006]): 2. Data sources include IBM Watson Micromedex (updated 3 May 2021), Cerner Multum™ (updated 4 May 2021), ASHP (updated 3 May 2021) and others. Arch Intern Med 150 (1990): 2077-81. Available for Android and iOS devices. Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance? The nurse obtains a complete family history of a client with a suspected endocrine disorder based on which rationale? A nurse is caring for a client with hypoparathyroidism. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. What intervention is the best response to this diagnosis? The nurse observes that the client has exophthalmos and neck swelling. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? Her primary care physician diagnoses her with the flu. A patient taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that he wants to stop taking them because of the increase in acne and moon face. The pathophysiological effects of the patient's tumor include excessive secretion of adrenocorticotropic hormone (ACTH). [Ref], Frequency not reported: Diarrhea, vomiting, abdominal cramps[Ref], Frequency not reported: Menstrual irregularities, impaired fertility[Ref], Frequency not reported: Serum sickness, hypersensitivity to inactive ingredients[Ref], Hypersensitivity reactions have occurred; however, it has been attributed to the inactive ingredients. Overtreatment with this drug may cause an increase in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients. 3. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. A patient is diagnosed with overactivity of the adrenal medulla. We comply with the HONcode standard for trustworthy health information. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. Hypersensitivity to levothyroxine itself is not known to occur. The nurse should be aware that the fluid and electrolyte disturbances associated with this disease create a significant risk of what problems? A client is admitted to the health care facility for evaluation for Addison's disease. Which of the following would the nurse expect to find? However, estrogen use appeared to negate the adverse effects of thyroid hormone on bone mineral density. The nurse notices that the client has large hands and a hoarse voice. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla? Chronic phase after failure of interferon-alpha therapy. A nurse is assessing a client with possible Cushing's syndrome. Cardiac function was evaluated in 20 patients requiring TSH suppression for either thyroid goiter or following thyroidectomy and radioactive iodine therapy for thyroid cancer and in 20 age and sex-matched controls. fast, slow, irregular, pounding, or racing heartbeat or pulse, pain or discomfort in the arms, jaw, back, or neck, swelling of the eyes, face, lips, throat, or tongue, lack or slowing of normal growth in children, redness of the face, neck, arms, and occasionally, upper chest. This patient will require the nurse to perform which of the following assessments most frequently? For which of the following patients would a nursing diagnosis of disturbed body image be most likely applicable? Over the following days, the woman begins to feel slightly better. The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to levothyroxine: compounding powder, injectable powder for injection, intravenous powder for injection, intravenous solution, oral capsule, oral solution, oral tablet. TSH suppression was associated with an increased incidence of premature ventricular beats, an increased left ventricular mass index, and enhanced left ventricular systolic function. Which symptom would the nurse not expect to see? Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? Although not all of these side effects may occur, if they do occur they may need medical attention. The PACU staff have brought a patient to the unit following a thyroidectomy. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. Which statement by the client indicates a need for additional teaching? Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Note: This document contains side effect information about levothyroxine. A 68-year-old woman becomes ill with a fever, cough, and muscle aches during the winter. Laboratory Tests. Abbott Pharmaceutical, Abbott Park, IL. The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. Which of the following would the nurse expect to find in a client with severe hyperthyroidism? Which nursing diagnosis should receive the highest priority? This study is a randomized, double-blinded, single-center, placebo-controlled phase 1&2 clinical trial in adults aged≥60 years. Postpartum: Occurs after a woman gives birth. Check with your doctor immediately if any of the following side effects occur while taking levothyroxine: Get emergency help immediately if any of the following symptoms of overdose occur while taking levothyroxine: Some side effects of levothyroxine may occur that usually do not need medical attention. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. Medically reviewed by Drugs.com. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to. To promote comfort for this patient, how should the nurse position this patient? Which of the following is a clinical manifestation of hypothyroidism? Some side effects may not be reported. When planning this patient's care, what diagnosis should be the nurse's most likely priority? Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Which of the following is a diagnostic sign of this disease? Which nursing diagnosis takes highest priority for a client with hyperthyroidism? Oh no! An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Administered after completion of RAIA in patients who have undergone total thyroidectomy; L-thyroxine also serves as hormone replacement therapy after surgery and RAIA. A 42-year-old man with a history of pheochromocytoma is being treated in the intensive care unit after experiencing an acute exacerbation of his condition. 3. As a result, this patient is likely to exhibit signs and symptoms that are characteristic of what endocrine disorder? What diagnosis do these clinical manifestations correlate with? Available from: URL: http://www.appco.com.au/appguide/default.asp." You may report them to the FDA. Australian prescription products guide online. Poorly differentiated thyroid cancer: adjuvant radiation therapy and/or chemotherapy as needed [8] [23] Nonoperative management. Synthroid (levothyroxine)." Which outcome indicates that treatment of a client with diabetes insipidus has been effective? A nurse is assessing a client after a thyroidectomy. Cardiac effects of hyperthyroidism include. 4. A nurse in a large university hospital has cared for several patients with endocrine disorders over the past year. A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. A nurse is assessing a client after a thyroidectomy. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Which would the nurse not include in this client's plan of care? What symptoms does the nurse recognize that are indicative of this emergency? What endocrine disorder should the nurse expect the physician to diagnose? The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. A nurse is planning care for a client in acute addisonian crisis. What does the nurse observe to verify this finding? The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. levothyroxine, Synthroid, Armour Thyroid, liothyronine, Levoxyl, Tirosint, Cytomel, NP Thyroid. During assessment, the nurse elicits a positive Trousseau's sign. A client with a history of hypertension is diagnosed with primary hyperaldosteronism. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. [Ref], Frequency not reported: Increased appetite, weight loss[Ref], Frequency not reported: Autoimmune disorders (e.g., chronic autoimmune thyroiditis)[Ref], Frequency not reported: Fatigue, heat intolerance, fever[Ref], Frequency not reported: Nervousness, anxiety, irritability, emotional lability[Ref]. The clinical significance of these changes remains to be determined. A patient has been admitted to an acute medical unit with a diagnosis of diabetes insipidus with a neurogenic etiology. Some of the dosage forms listed on this page may not apply to the brand name Euthyrox. Applies to levothyroxine: oral capsule liquid filled, oral solution, oral tablet. Which piece of equipment is most important for the nurse to keep at the client's bedside? A woman with a progressively enlarging neck comes into the clinic. An adult patient has undergone extensive testing that has resulted in a diagnosis of a basophilic pituitary tumor. When reviewing laboratory results for a patient with a possible diagnosis of hypoparathyroidism, the nurse knows that this condition is characterized by which of the following. Women taking daily doses of 1.6 mcg/kg or more had significantly lower bone mineral density levels at the ultradistal radius, midshaft radius, hip, and lumbar spine compared to controls. During an assessment of a patient with SIADH, the nurse notes the unexpected result of: The nurse is closely monitoring the blood work of a patient who has a diagnosis of primary hyperparathyroidism. These reactions have included urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. The proportion of abnormal markers of hematology, blood chemistry and urine analysis within 3 days after each dose of the recombinant SARS-CoV-2 vaccine (CHO cell) or placebo [ Time Frame: 3 days after each dose ] The proportion of serious adverse events up to Month 12 after prime and boost vaccination. During assessment, the nurse should stay alert for: A patient who is receiving treatment for hyperthyroidism is being monitored closely by the care team. Which of the following would the nurse expect to find? Cerner Multum, Inc. "UK Summary of Product Characteristics." A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. These side effects may go away during treatment as your body adjusts to the medicine. However, she wakes up one morning with fever, chills, worsening malaise, dyspnea, and a new productive cough. A study evaluated the effect of long-term thyroid hormone therapy on bone mineral density in 196 women (mean age, 74.4 years) compared to a control group comprised of 795 women (mean age, 72.1 years).
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