A patient with bipolar disorder has been taking lithium [Lithobid] for several years. The patient has developed a goiter, and serum tests reveal hypothyroidism. What will the nurse expect the provider to order for this patient?
a. Administration of levothyroxine
b. Increasing the lithium dose
c. Iodine supplements
d. Referral to an endocrinologist
A
Patients taking lithium may experience reduced incorporation of iodine into the thyroid hormone, resulting in goiter and hypothyroidism. Administration of levothyroxine or withdrawing the li-thium will reverse both. Increasing the lithium dose will make this worse. Iodine supplements are not indicated. The provider will either order stopping the lithium or administration of levothy-roxine, which will reverse this condition, so referral to an endocrinologist is not necessary.
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