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In: Nursing

Sandy Beeches, a 35-year-old accountant, presents to the office with complaints of nervousness, weakness and palpitations...

Sandy Beeches, a 35-year-old accountant, presents to the office with complaints of nervousness, weakness and palpitations for the past 6 months. Recently Sandy has noticed excessive sweating and wants to sleep with fewer blankets than her husband. Her weight has remained stable at 120 pounds but states “I have been eating twice as much as I did a year ago.” Sandy reports that her menstrual periods are irregular.

Physical assessment:   P=108 bpm, BP 132/64. Appears anxious; smooth, warm, moist skin and has a fine tremor.

  1. What do you suspect is Sandy’s diagnosis?   List the manifestations that helped you reach your conclusion.

  1. What laboratory tests do you anticipate may be ordered for Sandy? What results might you expect? (Be specific…)

The physician prescribes propylthiouracil (PTU) 100 mg orally 3 times daily.

  1. What labs are important to monitor prior to and during therapy with PTU?

  1. Explain the mechanism of action of propylthiouracil (PTU).

  1. Complete the first half of the medication template using propylthioruacil (PTU) as your prototype medication. BE SURE TO INCLUDE INSTRUCTIONS REGARDING HOW TO TAKE THIS MEDICATION AND LIST POTENTIAL ADVERSE EFFECTS THAT SANDY SHOULD REPORT TO THE PROVIDER IMMEDIATELY WHILE TAKING PTU. (use the back if you need additional room!)

After several months of therapy on PTU, Sandy’s condition doesn’t improve, and she has a total thyroidectomy. Sandy begins thyroid replacement therapy with levothyroxine (Synthroid) 88 mcg orally daily.

  1. How will you monitor for the therapeutic effects (of levothyroxine)?

  1. Complete the second half of the medication template using levothyroxine (Synthroid) as your prototype medication. BE SURE TO INCLUDE INSTRUCTIONS REGARDING HOW SANDY SHOULD TAKE THIS MEDICATION AND LIST THE POTENTIAL ADVERSE EFFECTS OF LEVOTHYROXINE.

Complete the System Disorder Active Learning Template on HYPOTHYROIDSM. In your paragraph, be sure to explain why Sandy was prescribed each type of thyroid medication, and why she had surgery.

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