A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?
A. Dysuria
B. Leg cramps
C. Tachycardia
D. Blurred vision
Correct Answer: C. Tachycardia
Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. Generally, adverse events resulting from incorrect dosing (excessive dosing) often form a hyperthyroid-like picture or due to an allergic reaction to the excipient of the levothyroxine tablets. The other options aren’t associated with levothyroxine.
Option A: Adverse effects (frequency undefined) include: angina pectoris, tachycardia, palpitations, arrhythmias, myocardial infarction, dyspnea, anxiety, fatigue, headache, heat intolerance, insomnia, irritability, diaphoresis, skin rash, alopecia, goiter, weight loss, menstrual irregularities, abdominal cramps, diarrhea, emesis, reduced fertility, and decreased bone mineral density (a result of TSH suppression).
Option B: In the initial stage of overdose (6 to 12 hours post-ingestion), the common signs of toxicity would be tremulousness, tachycardia, hypertension, anxiety, and diarrhea. Rarely, convulsions, thyroid storm, acute psychosis, arrhythmias, and acute myocardial infarction may occur.
Option D: In adults, monitor TSH levels approximately 6 to 8 weeks after initiating treatment with levothyroxine. Upon achieving the correct dosing of levothyroxine, monitor TSH levels 4 to 6 months after, and then every 12 months after that.
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