Question 1 asks the nurse to identify which assessment finding should prompt them to withhold a scheduled dose of levothyroxine for a 70-year-old resident of an assisted living facility. Levothyroxine is a medication commonly prescribed for individuals with hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. The medication works by replacing or providing the necessary amount of thyroid hormone in the body.
In this scenario, the options provided as potential assessment findings are as follows:
A) The resident has not eaten breakfast because of a recent loss of appetite.
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm.
C) The resident had a fall during the night while transferring from her bed to her bathroom.
D) The resident received her annual influenza vaccination the previous day.
In order to determine which assessment finding should prompt the nurse to withhold a dose of levothyroxine, it is important to understand the potential risks and side effects associated with the medication. Levothyroxine is known to increase heart rate and metabolism. Therefore, it is important to monitor for signs of hyperthyroidism, which may include an increased heart rate.
Option B states that the resident’s apical heart rate is 112 beats/minute with a regular rhythm. This finding indicates a higher heart rate than the typical resting heart rate for adults, which is generally between 60-100 beats/minute. Additionally, a heart rate of 112 beats/minute may be considered elevated and potentially indicative of hyperthyroidism.
Therefore, the nurse should withhold a scheduled dose of levothyroxine for this resident due to the elevated heart rate. The nurse should notify the primary care provider of the assessment finding and follow their instructions regarding further management of the resident’s levothyroxine therapy.
Moving on to question 2, it asks about the nurse’s close monitoring of a 33-year-old woman who has been prescribed simethicone for her irritable bowel syndrome (IBS). Simethicone is a medication commonly used to relieve symptoms of excess gas in the gastrointestinal tract. It works by breaking down gas bubbles and facilitating their passage.
The options provided as potential monitoring needs for the patient’s drug therapy are as follows:
A) Drug toxicity.
B) Anorexia.
C) Increased abdominal pain and vomiting.
D) Increased urine output.
When monitoring a patient on drug therapy, it is important to consider the specific pharmacological effects and potential adverse effects associated with the medication. In the case of simethicone, it is primarily used to relieve gastrointestinal symptoms such as bloating and gas. It is generally well-tolerated and has a low risk of adverse effects.
Out of the options provided, the one that is most relevant to monitor during the patient’s simethicone therapy is increased abdominal pain and vomiting. Although simethicone is commonly used to alleviate symptoms of gas and bloating, it is important to monitor for any worsening or new onset of abdominal pain and vomiting, as these symptoms may indicate an underlying condition or indicate a need for further evaluation or intervention.
Therefore, the nurse should closely monitor the patient for increased abdominal pain and vomiting during the course of her simethicone therapy. If these symptoms occur or worsen, the nurse should promptly notify the physician for further evaluation and guidance on managing the patient’s symptoms.
