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.
- What do you suspect is Sandy’s diagnosis?
List the manifestations that helped you reach your
conclusion.
- 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.
- What labs are important to monitor prior to and
during therapy with PTU?
- Explain the mechanism of action of propylthiouracil
(PTU).
- 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.
- How will you monitor for the therapeutic effects
(of levothyroxine)?
- 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.
REFERENCES