A client with coronary artery disease recently had the levothyroxine dose increased. The client now has weight…

Question

A client with coronary artery disease recently had the levothyroxine dose increased. The client now has weight loss, a suppressed TSH level, and atrial fibrillation with a rapid ventricular response. Which action should the nurse take first?

Accepted Answer

Option 4: Hold the next dose, apply cardiac monitoring, notify the provider, and assess for ischemia.

The suppressed TSH level, weight loss, and rapid atrial fibrillation after a dose increase indicate levothyroxine over-replacement. In a client with coronary artery disease, the nurse should hold the next dose, monitor the cardiac rhythm, notify the provider, and assess for chest pain or ischemia. Continuing or increasing levothyroxine could worsen the dysrhythmia. Atropine increases heart rate and is inappropriate for atrial fibrillation with a rapid ventricular response.

Answer

Option 1: Continue the current dose and arrange routine thyroid testing in 4 weeks.

Answer

Option 2: Administer atropine for the rapid heart rate and continue the current dose.

Answer

Option 3: Increase the dose because weight loss and tachycardia indicate persistent hypothyroidism.

A client with coronary artery disease recently had the levothyroxine dose increased. The client now has weight loss, a suppressed TSH level, and atrial fibrillation with a rapid ventricular response. Which action should the nurse take first?

In-depth explanation

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A client with coronary artery disease recently had the levothyroxine dose increased. The client now has weight loss, a suppressed TSH level, and atrial fibrillation with a rapid ventricular response. Which action should the nurse take first?

In-depth explanation

Master the NCLEX-RN with MyMerci