A patient arrives in the emergency department with a heart rate of 128 beats per minute and a temperature of 105? F. The patient's skin feels hot and moist
The free T4 level is 4 ng/dL, the free T3 level is 685 pg/dL, and the TSH level is 0.1 microunits/mL. The nurse caring for this patient will expect to administer:
a. intravenous levothyroxine.
b. iodine-131 (131I).
c. methimazole (Tapazole).
d. propylthiouracil (PTU).
ANS: D
Propylthiouracil is used for patients experiencing thyroid storm, and this patient is showing signs of that condition. Levothyroxine is given IV for hypothyroidism. 131I is used in patients over age 30 who have not responded to other therapies. Methimazole is used long term to treat hyperthyroidism, but PTU is more useful for emergency treatment.
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