A 49-year-old woman (5’2″, 170 lbs) comes to your clinic with a chief complaint of feeling poorly for the past
few months. When asked for more details, she complains of a list of symptoms including fatigue, cold
intolerance, weight gain, and constipation. Her physical appearance is normal except for a noticeable yellow tint
to her skin, and puffiness of her face. Her thyroid gland appears firm and enlarged. Her lab tests indicate free
thyroxine (FT4) = 0.5 ng/dL (normal: 0.7-1.9); TSH = 70 IU/ml (normal: 0.5-4.7); thryoperoxidase antibodies =
140 IU/L (normal <100).
1.What is the most likely diagnosis?
- What medications could be prescribed to treat this client?
- What are signs of euthyroidism
Antivirals
John Jones is a 55-year-old African American man. He has been HIV positive for 5 years. He is currently taking
Atripla one tablet by mouth daily. He presents to the physician’s office complaining of pain in his mouth and
white patches on his tongue and cheeks. - While triaging Mr. Jones, what information should the nurse obtain?
- Mr. Jones tells the nurse he has started taking St. John’s wort because he heard it had antiviral effects and he
was feeling a bit depressed lately. What should the nurse tell Mr. Jones about the St. John’s wort? - The physician writes a prescription for Mr. Jones to receive fluconazole (Diflucan) 200 mg on day 1 and 100
mg on days 2 through 14. What should the nurse tell Mr. Jones? - What patient teaching will the nurse provide Mr. Jones for the Atripla that is prescribed ?
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