A client is admitted to the hospital for treatment of a simple goiter, and levothyroxine sodium is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client?
Bradycardia and constipation.
Muscle cramping and dry, flushed skin.
Palpitations and shortness of breath.
Lethargy and lack of appetite.
The Correct Answer is C
A. Bradycardia and constipation are symptoms associated with hypothyroidism, not hyperthyroidism, indicating that the dosage may be too low rather than too high.
B. Muscle cramping and dry, flushed skin are not typical indicators of levothyroxine overdose and may reflect other underlying issues.
C. Palpitations and shortness of breath are symptoms indicative of hyperthyroidism, suggesting that the levothyroxine dosage may be too high, leading to an increased metabolic rate and cardiovascular stress.
D. Lethargy and lack of appetite are more consistent with under-treatment or hypothyroidism rather than an overdose of levothyroxine, which typically stimulates metabolic activity.
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Correct Answer is C
Explanation
A. Immediately after the patient has been medicated for pain.
While pain relief may help, education should be conducted when the patient is alert and comfortable, not immediately after pain medication when they may be drowsy.
B. The last thing in the evening, after visitors have left, before bedtime. Education right before bedtime may not be effective if the patient is tired, as retention and attention may be reduced.
C. When the patient is comfortable and receptive to the patient education.
Teaching should occur when the patient is comfortable, alert, and receptive to ensure they can retain and understand the information.
D. Just before the patient is discharged, so the information is current.
Waiting until discharge could overwhelm the patient, and they may not have time to ask questions or clarify information.
Correct Answer is C
Explanation
A. Bradycardia and constipation are symptoms associated with hypothyroidism, not hyperthyroidism, indicating that the dosage may be too low rather than too high.
B. Muscle cramping and dry, flushed skin are not typical indicators of levothyroxine overdose and may reflect other underlying issues.
C. Palpitations and shortness of breath are symptoms indicative of hyperthyroidism, suggesting that the levothyroxine dosage may be too high, leading to an increased metabolic rate and cardiovascular stress.
D. Lethargy and lack of appetite are more consistent with under-treatment or hypothyroidism rather than an overdose of levothyroxine, which typically stimulates metabolic activity.