Applied Sciences assignment due at 11:59 tonight

Gladys Centeno

Unit 4 resubmitted assignment

Monitoring the patient’s TSH and T4 values is a reliable source to know whether levothyroxine therapy has been effective. In hypothyroidism, TSH levels tend to be elevated and signal the thyroid gland to produce more hormones. As treatment starts the TSH levels will trend closer toward the normal range and the free T4 levels. The results can be read by a healthcare professional to make a decision about medication maintenance , to see if the patient is adequately medicated or needs dosage adjustments.

You want to remind the patient that levothyroxine takes time to work and that symptoms will not go away immediately. He may start to notice that he is having more energy and better concentration within a few weeks, however other symptoms can take longer to improve. Problems that may arise would be constipation and dry skin, it shall improve as the thyroid levels become more balanced. The patient may see some weight changes while taking levothyroxine. It’s important to remind the patient to take the medication every day at the same time on an empty stomach as well as keeping up with follow-up appointments and lab work to make sure the treatment is effective. (Lilley et al., 2022).

Educate the patient that he should contact his healthcare provider if he starts experiencing a fast or irregular heartbeat, shaking, sweating, nervousness, trouble sleeping, or unexplained weight loss. These symptoms could mean that the dose of levothyroxine is too high. He should also report any unusual changes in how he feels so the provider can determine if his medication needs to be adjusted.

I would recommend acetaminophen or ibuprofen to help bring down the child's fever and relieve her sore throat and body aches. Since she weighs 44 pounds, which is about 20 kilograms, the recommended acetaminophen dose would be 200–300 mg per dose. For ibuprofen, the dose would be approximately 100–200 mg per dose. The correct amount should be checked based on the medication concentration and the child's age and weight. Acetaminophen helps with pain and fever, while ibuprofen also helps reduce inflammation. Ibuprofen should be avoided if the child is dehydrated or has certain kidney problems. Mrs. Garcia should contact the healthcare provider if her daughter's symptoms get worse or do not improve (MedlinePlus, n.d.).

I would not recommend giving this child aspirin because it can increase the risk of Reye syndrome, which is a rare but serious condition that can affect the brain and liver in children and teenagers with certain viral infections. Since the child is already experiencing a fever, sore throat, and body aches, it is safer to use acetaminophen or ibuprofen as directed. Mrs. Garcia should also watch for any worsening symptoms. If her daughter has trouble breathing or swallowing, signs of dehydration, unusual sleepiness, or other concerning symptoms, she should receive medical attention right away (Centers for Disease Control and Prevention [CDC], n.d.).

Gout happens when too much uric acid builds up in the body and forms crystals in the joints. This can cause sudden pain, swelling, redness, and inflammation, especially in the big toe. Allopurinol works by slowing down an enzyme called xanthine oxidase, which helps reduce how much uric acid the body makes. The patient needs to take this medication every day, even when he is not having pain. It is important to understand that allopurinol is used to prevent future gout attacks and is not meant to provide immediate relief during an attack (FitzGerald et al., 2020).

The patient should make some changes to his diet to help manage his gout. He should try to avoid or limit foods that are high in purines, such as organ meats, certain seafood, and large amounts of red meat. He should also limit alcohol, especially beer and liquor, because these can increase uric acid levels and trigger gout attacks. Sugary drinks with high amounts of fructose should also be limited. Maintaining a healthy weight and staying physically active can also help. Making these changes while continuing his medication can help lower uric acid levels and reduce future gout flare-ups (FitzGerald et al., 2020).

It is important for the patient to drink enough water throughout the day while taking allopurinol. Drinking around 2–3 liters daily may be appropriate if his healthcare provider recommends it. Staying hydrated helps the kidneys function properly and may lower the risk of kidney stones. He should be especially careful not to become dehydrated when exercising or spending time outside in hot weather. If the patient has kidney problems, heart failure, or has been told to limit fluids, he should speak with his healthcare provider before increasing his water intake (FitzGerald et al., 2020).

The patient should not stop taking allopurinol on his own if he experiences another gout attack after starting the medication. Gout flare-ups can still happen during the first few months of treatment while the uric acid levels are changing. He should continue taking the medication as prescribed and contact his healthcare provider for help managing the pain and inflammation. The provider may recommend medications such as colchicine, an NSAID, or a corticosteroid to help with the flare-up. However, if the patient develops a rash, blisters, sores in his mouth, or swelling of the face, he should stop taking allopurinol and seek medical attention immediately because these could be signs of a serious allergic reaction (FitzGerald et al., 2020; U.S. National Library of Medicine, n.d.).

Finasteride is a medication used to treat benign prostatic hyperplasia (BPH), which means the prostate gland has become enlarged. When the prostate gets bigger, it can put pressure on the urethra and make it harder for a man to urinate. Some symptoms include having a weak urine stream, difficulty starting to urinate, and not being able to empty the bladder completely. Finasteride works by blocking an enzyme called 5-alpha-reductase, which helps convert testosterone into a hormone called DHT. DHT contributes to prostate enlargement. By lowering DHT levels, finasteride can gradually shrink the prostate and improve urine flow. The patient should understand that this medication takes time to work, and it may take several months before he notices an improvement in his symptoms (U.S. National Library of Medicine, n.d.).

Finasteride should not be used by pregnant women because it can affect the development of the reproductive organs of a male fetus. Women who are pregnant or could become pregnant should not touch crushed or broken finasteride tablets because the medication can be absorbed through the skin. If a woman accidentally touches a broken tablet, she should wash the area immediately with soap and water. She should also contact a healthcare professional for further instructions (U.S. National Library of Medicine, n.d.).

The patient should keep finasteride in its original container and store it at room temperature in a dry place. The tablets should be swallowed whole and should not be crushed or broken. This is especially important because women who are pregnant or may become pregnant should not come into contact with damaged tablets. If a tablet becomes broken or damaged, the patient should avoid handling it and ask the pharmacist how to properly dispose of it. Following these instructions helps prevent accidental exposure and keeps the medication stored safely (U.S. National Library of Medicine, n.d.).

Centers for Disease Control and Prevention. (n.d.). Reye syndrome. https://www.cdc.gov/

DailyMed. (n.d.). Levothyroxine sodium tablet: Prescribing information. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/

FitzGerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A. M., et al. (2020). 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care & Research, 72(6), 744–760. https://doi.org/10.1002/acr.24180

Lilley, L. L., Collins, S. R., & Snyder, J. S. (2022). Pharmacology and the nursing process (10th ed.). Elsevier.