Endocrine case study 2 MED SURGE 1 PDF

Preview

Summary

ENDOCRINE ASSIGNMENT CASE STUDY ASSIGNMENT MED SURHE 1...

Description

ENDOCRINE CASE STUDY Genevieve is a 45-year-old woman with three children who works part time and has recently returned to nursing school. She has sought care from her primary care provider. While taking a health history, Genevieve tells the nurse that she has noticed that she is feeling very tired, is cold all of the time, and has gained 15 pounds without a change in eating habits. 1. What other symptoms could accompany hypothyroidism? Other symptoms that could accompany hypothyroidism include hypotension, bradycardia, decreased contractility, decreased cardiac output, constipation, slowed metabolism, slow speech, hair loss, brittle nails, dry skin, numbness/tingling in fingers, goiter, slowed mental processes, and myxedema. Genevieve’s provider performs an assessment, noting that she has cool skin, brittle nails, coarse and dry hair, slight abdominal distension, and poor wound healing on an older cut. The provider orders laboratory work. 2. Which laboratory tests would assist in confirming a diagnosis of hypothyroidism? Laboratory tests that would assist in confirming a diagnosis of hypothyroidism include T3 serum levels, T4 serum levels, TSH levels, and iodine levels. Laboratory results indicate a decreased T3 and T4, and a high level of TSH. Genevieve is diagnosed with hypothyroidism, and placed on levothyroxine (Synthroid).

3. What priority concerns should the nurse identify? The nurse should identify the following priority concerns: monitor the patient’s respiratory status and identify oxygenation needs; monitor apical heart rate during the initiation of the medication; make sure the patient takes the medication with a full glass of water 30min-1hr before eating; make sure the patient does not crush, chew, or split medication that is in capsule form; make sure the patient is taking the medication 4 hours from taking any antacids, cholesterol reducers, and calcium supplements.

Ed is a 17-year-old football player who experienced a head injury while playing football. Ed was diagnosed with traumatic brain injury (TBI) and is currently undergoing TBI rehabilitation. 1. What signs and symptoms would alert the nurse to the possible post-trauma complication of diabetes insipidus (DI)? Confusion, lethargy, nocturia, fatigue, tachycardia, decreased blood pressure, dehydration, and increased thirst are all symptoms of diabetes insipidus.

2. What laboratory findings are consistent with DI? Increased urine output up to 20L a day, decreased specific gravity, increased serum osmo >300 mOsm (water deprivation test), hypernatremia, hypovolemia, increased blood pressure and heart rate

The primary care provider has prescribed desmopressin, 10 mcg nasally every 8-12 hours. 3. What teaching points should the nurse provide to Ed regarding nasal inhalation of desmopressin? Take the dose at the same time everyday. If you miss a dose, you can take it when you remember it, however if it is close to when you need to take the next dose, then skip the missed dose. Side effects include stomach pain, heartburn, difficulty falling asleep or staying asleep, nose bleeds, nasal pain and discomfort, itchy and light-sensitive eyes, and sore throat. You MUST contact your healthcare provider if experiencing vomiting, chest pain, rash, hives, itching, and difficulty breathing or swallowing....