Registered Nurse (RN) Endocrine Licensure Exam

For a patient receiving IV Synthroid for myxedema coma, which finding requires nursing intervention?

1. Blood glucose level of 75

2. Sodium level of 138

3. Fentanyl 0.25 mcg every 2 hours ordered by the physician

4. Temperature of 98.9°F

The correct answer is: Fentanyl 0.25 mcg every 2 hours ordered by the physician

When a patient is receiving IV Synthroid (levothyroxine) for myxedema coma, it's crucial to monitor their medications and potential drug interactions carefully. In this context, the administration of fentanyl at the specified dose raises a significant concern. Fentanyl is an opioid analgesic that can lead to respiratory depression, especially in patients with underlying conditions or those receiving other central nervous system depressants. Patients with myxedema coma often have compromised respiratory function, and the use of opioids can exacerbate this issue. Therefore, it is essential to assess the necessity of opioid analgesia in this patient. Monitoring the patient for signs of respiratory depression or decreased level of consciousness is crucial when opioids are prescribed. If the patient exhibits any concerning signs, or if fentanyl's use is deemed unnecessary given the patient's condition, nursing intervention to reassess the appropriateness of this medication would be warranted. The other findings—blood glucose level, sodium level, and temperature—are within normal ranges and do not indicate an immediate need for nursing intervention. Maintaining vigilance regarding the patient's respiratory status and ensuring the safety of medication administration is essential in this scenario.