NURS 2516 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

Levothyroxine Synthroid hormones 0.05 mg PO Daily
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
1-3 wk unknown 1-3 wk

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered)
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)
Contraindications/warnings/interactions
Hypersensitivity, Recent MI, Thyrotoxicosis/ Use cautiously in pt’s with
severe cardiac disease, renal insufficiency, uncorrected adrenocortical
disorders, and swallowing difficulty. Geriatric patients are extremely
sensitive to thyroid hormones in general and initial dosage should be
markedly reduced. Interacts w/ adrenergics and beta blockers.
Common side effects
arrhythmias, tachycardia, insomnia, irritability, nervousness, weight loss,

Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
May decrease response to beta blockers (pt takes Coreg)
Nursing Process- Assessment
(Pre-administration assessment)
Check pulse rate, weigh pt, and ask pt about insomnia,
irritability and nervousness.
Lab value alterations caused by medicine
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.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Diuresis, weight loss, Increased
You would hold the dose and contact the sense of well-being, energy, pulse
physician if the pulse was higher than 100 rate and apetite, Normalization of
bpm and or if the patient has had significant skin texture and hair and
weight loss. correction of constipation