Page 1443 - Saunders Comprehensive Review For NCLEX-RN

6. Monitor blood pressure.
7. Instruct the client in how to use the intranasal
medication.
8. Instruct the client to weigh herself or himself daily to
identify weight gain.
9. Instruct the client to report signs of water intoxication
or symptoms of headache or shortness of breath.
III. Thyroid Hormones (Box 47-2)
A. Description

1. Thyroid hormones control the metabolic rate of

tissues and accelerate heat production and oxygen
consumption.
2. Thyroid hormones are used to replace the thyroid
hormone deficit in conditions such as
hypothyroidism and myxedema coma.
3. Thyroid hormones enhance the action of oral
anticoagulants, sympathomimetics, and
antidepressants and decrease the action of insulin,
oral hypoglycemics, and digitalis preparations; the
action of thyroid hormones is decreased by phenytoin
and carbamazepine.

4. Thyroid hormones should be given at least 4

hours apart from multivitamins, aluminum hydroxide
and magnesium hydroxide, simethicone, calcium
carbonate, phosphate binders, bile acid sequestrants,
iron, and sucralfate, because these medications
decrease the absorption of thyroid replacements.

B. Side and adverse effects

1. Nausea and decreased appetite
2. Abdominal cramps and diarrhea
3. Weight loss
4. Nervousness and tremors
5. Insomnia
6. Sweating
7. Heat intolerance
8. Tachycardia, dysrhythmias, palpitations, chest pain
9. Hypertension
10. Headache
11. Toxicity: Hyperthyroidism
C. Interventions
1. Assess the client for a history of medications currently
being taken.
2. Monitor vital signs.
3. Monitor weight.

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