Juanita, age 23, complains of palpitations that started a few weeks ago; they occur 2 to 4 times a day and last 5 to 10 minutes. She feels nervous and is having trouble sleeping. Her stools have been frequent (1-3 per day) and loose. She is taking levothyroxine 150 µg daily. Her labs indicate free thyroxine (T4) 2.28 and thyroid-stimulating hormone (TSH) 0.022. She has a history of Graves disease and had radioactive iodine (RAI) treatment a few months ago. She has been on thyroid replacement for 2 months. Based on these data, you decide to .1. Increase the levothyroxine dosage.
2. Decrease the levothyroxine dosage.
3. Keep the dosage the same.
4. Start propranolol every 8 hours.

(2) Decrease the levothyroxine dosage.

Explanation:

Palpitation refers to an unusually quick, heavy, or erratic heartbeat triggered by agitation, exertion, or illness. Juanita has palpitation and also a record of graves disease (

Graves' disease is an immune system disorder that results in the overproduction of thyroid hormones).Thyroid replacement hormones are medications is used in treating when the production of thyroid hormone in the body is abnormally low.

Levothyroxine is a type of thyroid hormone thyroxine which has been developed. It is used to treat lack of thyroid hormones. Too much intake of levothyroxine causes symptoms of overactive thyroid, including fatigue, sensitivity to heat, increased appetite, and sweating.

So if juanita decreases her intake of levothyroxine it would help in treating the palpitation she is experiencing.

The correct answer to the question is option 2

DECREASE THE LEVOTHYROXINE DOSAGE.

Explanation:. Levothyroxine is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery.

One of the main concerns with starting levothyroxine replacement is myocardial ischemia or arrhythmias and heart palpitations which, although rare, are known to occur.

Some of the side effects of levothyroxine are;increased appetite,weight loss,heat sensitivity,excessive sweating,headache,hyperactivity, nervousness and anxiety.

This shows that Juanita is obviously experiencing an adverse effect of the levothyroxine medication that she is on,so reduction in the dosage of the levothyroxine will make her feel better and as well bring about a relief.

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