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NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name

Trade Name Synthroid

Classification hormones

Dose

Route

Time/frequency

50 mcg

PO

Daily

Levothyroxine

Peak 1-3 wk

Onset unknown

Duration 1-3 wk

Normal dosage range Usual maintenance dose is 75-125 mcg/day

Why is your patient getting this medication Hypothyroidism

For IV meds, compatibility with IV drips and/or solutions N/A

Mechanism of action and indications (Why med ordered)

Nursing Implications (what to focus on) Contraindications/warnings/interactions

Principal effect is increasing metabolic rate of body tissues, ex: Promote gluconeogenesis, Increase utilization and mobilization of glycogen stores, Stimulate protein synthesis, Promote cell growth and differentiation Indicated for replacement/substitution in diminished or absent thyroid function (hypothyroidism)

Hypersensitivity, Recent MI, Thyrotoxicosis/ Use cautiously in pt’s with severe cardiac disease, renal insufficiency, uncorrected adrenocortical disorders, and swallowing difficulty .

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)

Lab value alterations caused by medicine

none

Common side effects arrhythmias, tachycardia, insomnia, irritability, nervousness, weight loss

If the pt becomes toxic, it will be manifested in hyperthyroidism that can range from a little serous to very serious depending on how high the levels of thyroid hormones are.

Be sure to teach the patient the following about this medication Instruct patient to take medication as directed at the same time each day. Take missed doses as soon as remembered unless almost time for next dose. If more than 2-3 doses are missed, notify health care professional. Do not discontinue without consulting health care professional. Instruct patient and family on correct technique for checking pulse. Dose should be withheld and health care professional notified if resting pulse >100 bpm. Explain to patient that medication does not cure hypothyroidism; it provides a thyroid hormone. Therapy is lifelong. Advise patient to notify health care professional if headache, nervousness, diarrhea, excessive sweating, heat intolerance, chest pain, increased pulse rate, palpitations, weight loss >2 lb/wk, or any unusual symptoms occur. Emphasize importance of follow-up exams to monitor effectiveness of therapy. Thyroid function tests are performed at least yearly.

Nursing Process- Assessment (Pre-administration assessment) Check pulse rate, weigh pt, and ask pt about insomnia, irritability and nervousness.

Assessment Why would you hold or not give this med? You would hold the dose and contact the physician if the pulse was higher than 100 bpm and or if the patient has had significant weight loss.

Evaluation Check after giving Diuresis, weight loss, Increased sense of well-being, energy, pulse rate and apetite, Normalization of skin texture and hair and correction of constipation