pharm 3 ADVANCED.

pharm 3 ADVANCED.A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient's thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe: - ANSWERS.This patient has hypothyroidism and should be treated with *levothyroxine. Methimazole is a thyroid suppressant. Liothyronine is synthetic T3. Propylthiouracil is a thyroid suppressant. A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks. The patient reports continued fatigue. The primary care NP should: - ANSWERS.Check the TSH level in 1 week. Full therapeutic effectiveness may not be achieved for 3 to 6 weeks. Measuring the TSH level is indicated to evaluate drug effectiveness. The dose should not be increased without first evaluating the patient's TSH level. A primary care NP orders thyroid function tests. The patient's TSH is 1.2 microunits/mL, and T4 is 1.7 ng/mL. The NP should: - ANSWERS.Tell the patient that the results most likely indicate hypothyroidism. Primary hypothyroidism is the most common form of hypothyroidism. Use of certain drugs, such as lithium, and diseases such as Hashimoto's thyroiditis can cause hypothyroidism but are less likely. The patient does not have signs of hyperthyroidism. An 80-year-old female patient with a history of angina has increased TSH and decreased T4. The primary care NP should prescribe _____ mcg of _____. - ANSWERS.Elderly individuals may experience exacerbation of cardiovascular disease and angina with thyroid hormone replacement. It is advisable to start low at *25 mcg and work up as tolerated. Liothyronine is a synthetic T3. A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: - ANSWERS.Stopping the medication & checking TSH & T4 in 4 weeks. In congenital hypothyroidism, therapy may be stopped for 2 to 8 weeks after the pt reaches 3 years of age. If TSH levels remain normal, thyroid supplementation may be discontinued permanently. A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication, the NP should: - ANSWERS.Tell the patient that changing brands should be avoided. Patients should be told not to change brands of the med; there is potential variability in bioequivalence between manufacturers. The medication should be taken at approximately the same time each day before breakfast or on an empty stomach. Patients should be instructed to