Thyroid Case Study
Mrs. Duarte is a 40 year old female who has scheduled anappointment with her PCP to assess a lump that has developed on theleft side of her neck.
Mrs. Duarte explains to her PCP that she has noticed a swollenarea on the left side of her neck that has been increasing in size.She states, “I am really afraid I have cancer. I eat plenty offood, but seem to be losing weight. I have lost 10 lbs in less than2 months. I have been very agitated and irritable. Perhaps I amnervous about the possibility that this lump is cancer.” Her VSinclude BP 142/64, HR 128, RR 24, and temperature 98.8 degrees F.The PCP notes that Mrs. Duarte’s hands have a fine tremor, and shehas mild periorbital edema indicative of exophthamlmos. On physicalassessment, the PCP palpates a smooth, soft, enlarged left lobe ofthe thyroid gland. The PCP places the bell of the stethoscope overthe swollen area and auscultates a bruit. Further discussionreveals that Mrs. Duarte has been having difficulty sleeping,thinning hair, and loose bowel movements. Concerned about a thyroiddisorder, the PCP prescribes serum laboratory testing to assess theclient’s level of TSH, T3 & T4, and schedules the client for aradioactive iodine uptake test.
- Does the PCP suspect that Mrs. Duarte has hypo orhyperthyroidism? Identify the clinical manifestations that supportyour answer.
- Identify 3 nursing diagnoses appropriate for Mrs. Duarte.Indicate which of the 3 diagnoses would be the priority nursingdiagnosis and provide your rationale – include nursing diagnosis,related to (r/t), and as evidenced by (AEB) statements.
- What do you suspect Mrs. Duarte’s findings will reveal for herlab and diagnostic tests – indicate increase, decrease, or resultsfor TSH, T3, T4, and radioactive iodine uptake test.
- Mrs. Duarte develops hypothyroidism following her radioactiveiodine therapy. Her PCP prescribes levothyroxine. She asks thenurse, “What is this medication for and how long will I need totake it?” Provide the patient with teaching regarding the rationalefor the prescribed medication & respond to her questionregarding the length of treatment needed. Also, include 3 otherteaching points you would want to educate the patient on regardingthis medication.
