Question

The patient is a 43-year-old woman who is sched

a hysterectomy later today. During her preadmission testing,
her vital signs are T = 100, P = 88 with several "skipped" beats,
20, BP 160/148. She is 5'6" and weighs 110 lb. Her
levothyroxine (Synthroid) 200 mcg daily, and aspirin 81 mg
current drugs are metoprolol (Toprol 50 mg) for hypertension,
that her blood pressure problem is being managed and that
daily. When you ask her about her hypertension, she shouts
you should focus on her impending surgery. Then she apolo-
gizes for her behavior and says that she has not been sleeping
well lately, probably because of worrying about the scheduled
surgery.
Enerbilio
1. What type of drug is levothyroxine?
2. What are the side effects of this drug?
3. Which, if any, vital sign abnormalities, patient-reported
signs or symptoms, and observed physical attributes and
behavior(s) could be attributed to this drug? Provide
rationales for your selections.
4. What should you do with this information?

Answer 1

1. Levothyroxine is a synthetic hormone medication used to replace the naturally produced hormone, thyroxine (T4), which is solely responsible for regulating metabolism.

2. The most common side effects of levothyroxine include headache, nausea, vomiting, appetite changes, hair loss, and insomnia.

3. In this case, the elevated blood pressure (BP 160/148) can be attributed to the levothyroxine as the patient is taking this in addition to the metoprolol (Toprol 50 mg) for hypertension. Additionally, her behavior (shouting before apologizing) could also be attributed to the levothyroxine as one of the side effects is insomnia which can cause irritability, fatigue, and difficulty concentrating.

4. With this information, you should take note of the side effects of levothyroxine and be aware that the patient is taking two medications to control her hypertension. Encourage her to get a good night's sleep before the surgery so she is rested and in a better mental state for the procedure.