You are working in a community outpatient clinic where you perform the intake assessment on R.M.,...

You are working in a community outpatient clinic where you perform the intake assessment on R.M., a 38-year-old woman. She is being worked up for endocrine disease based upon her symptoms- fatigue, weight gain of 15 pounds over 2 months, frequent muscle cramps and constipation. R.M is diagnosed with myxedema and immediately started on levothyroxine sodium.

How does levothyroxine sodium treat hypothyroidism?

What baseline assessment and data is needed prior to initiating treatment with levothyroxine sodium?

What are the nursing interventions for this patient?

What should be included in patient teaching for R.M? Explain your answer.

R.M tells you “I forgot to tell you that I take metformin daily to help my sugars. I was just given that last week.” What is metformin and how does it work?

What additional teaching is necessary? What concerns do you have?

Expert Solution

Hypothyroidism is a condition in which the thyroid gland doesn't produce enough thyroid hormone.Levothyroxine is a synthetic form of thyroxine (T4), an endogenous hormone secreted by the thyroid gland, which is converted to its active metabolite, L-triiodothyronine (T3). Levothyroxine is a synthetic prohormone proven to be effective in the management of hypothyroidism. It reduces symptoms by increasing thyroid hormone levels.

Before the treatement for hypothyroidism initially many things has to be noted such as levothyroxine is contraindicated in patients with untreated subclinical (suppressed serum TSH level with normal T3 and T4 levels) or overt thyrotoxicosis of any etiology and in patients with acute myocardial infarction. Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids.

Metformin hydrochloride is a type of antidiabetic medicine called a biguanide. It works in a number of ways to lower blood sugar levels in people with type 2 diabetes. This works to lower the amount of sugar in the blood of people with diabetes. It does this by lowering the amount of sugar produced in the liver, and also increasing the sensitivity of muscle cells to insulin.

Nightingale answered 2 years ago

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You are working in a community outpatient clinic where you perform the intake assessment on R.M.,...

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