Hypothyroidism Case Study

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1) post-ablative hypothyroidism – uncontrolled
drug therapy problem – safety: dose too high – NM is experiencing hyperthyroidism symptoms such as improved energy and motivation, loss weight, increased heart rate, excessive and frequent stools, low TSH, high free T4 because her 112mcg dose of levothyroxine is too high.

The treatment goal is to maintain TSH, T4 free within normal range without experiencing any symptomatic side effects such as fatigue, weight gain, decreased heart rate, depression for hypothyroidism and increased heart rate, sudden weight loss, increased appetite, anxiety for hyperthyroidism.

Based on the 2012 Clinical Practice Guidelines for Hypothyroidism, levothyroxine is the preferred medication. Regarding the dosing, 1.6 mcg to 1.7 mcg/kg/day is mean …show more content…

Regarding her post-ablative hypothyroidism, it is important to avoid the unpredictable pregnancy in case not aware of changing the dose independently.

3) general health – controlled
The goal of BMI is 18.5 to 24.9 indefinitely. Her BMI is 24.6, which meets the goal.

Plan:
1) Post-ablative hypothyroidism
-Initiate levothyroxine 100 mcg tablet: take 1 tablet by mouth once daily.
-Discontinue levothyroxine 112 mcg tablet: take 1 tablet by mouth once daily
-Instruct the patient to take the tablet with a full glass consistently 30 to 60 minutes before breakfast or at bedtime 4 hours after the last meal.
-Advise patient to expect improvement of symptoms in 2 to 3 weeks.
-Educate patient that this medication may reduce the absorption of antacids, calcium, and iron. Take 4 hours apart from antacids, calcium and iron supplements.
-Educate on the side effects including fatigue, heat intolerance, fever, sweating, hyperactivity, tremors, palpitations, myocardial infarction.

2)

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