If a client states, "Sometimes I feel dizzy and my heart pounds," while on levothyroxine, what action requires immediate follow-up by the nurse?

The statement from the client about experiencing dizziness and a pounding heart can indicate symptoms of hyperthyroidism, which can occur if the dosage of levothyroxine is too high. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism by replacing the deficient hormone. If the hormone levels in the body become excessive, it can result in hyperthyroidism-like symptoms, such as palpitations, anxiety, and dizziness.

Immediate follow-up is necessary because potential hyperthyroidism can lead to serious complications, including cardiovascular issues, especially in those with preexisting heart conditions. The nurse should assess the thyroid hormone levels and evaluate the client's symptoms further to ensure that the dosage of levothyroxine is appropriate. Monitoring and adjusting the dosage is crucial for the safety and well-being of the client.

While dizziness and a pounding heart might be considered common side effects of certain medications, in this context with levothyroxine, they signal a need for evaluation. Discontinuing the medication immediately without proper assessment could lead to worsening symptoms of hypothyroidism. Monitoring dietary intake is important as well but is not as immediate a concern as the potential for hyperthyroidism.