Joe Clark, a 56-year-old male client, is postoperative 6 weeks after a total laryngectomy with a radical neck approach and reconstruction of the neck. He communicates via a Blom Singer prosthesis. Before surgery, he received 6 weeks of external beam radiation to help shrink the cancerous tumor. He has a past history of a kidney stone, which he passed. He had an intravenous pyleography (IVP) 2 months ago. He presents to the outpatient clinic for follow-up. He stated that he feels extremely tired, and has problems remembering things and has to write lists as soon as he thinks of things he needs to do, or he forgets. He has experienced a recent hair loss and dry skin and stated he feels cold all the time. The nurse notes that he is wearing a sweater and it is 80° F outside. The client has periorbital edema and puffiness of the hands and feet, which are cool to touch. The vital signs are T, 97° F; BP, 90/50 mm Hg; HR, 55 beats/minute; RR, 12 breaths/minute. He also reports a recent steady weight gain, and he eats less food than he did in the past because his appetite is decreased. He asks the LPN/LVN to explain the reason for the thyroid panel the physician ordered.
What nursing management related to the diagnostic tests is necessary for the client considering the history?
Patient symptoms like - bradycardia, hypothermia, hypotension, weight gain, periorbital edema, alopecia,dry skin
Correlate with hypothyroidism condition of patient
Iatrogenic or do to radiation damage to thyroid gland
Diagnostic tests- thyroid hormones profile- T3 and T4 level
TEST for TSH level
USG neck
Joe Clark, a 56-year-old male client, is postoperative 6 weeks after a total laryngectomy with a...
Joe Clark, a 56-year-old male client, is postoperative 6 weeks after a total laryngectomy with a radical neck approach and reconstruction of the neck. He communicates via a Blom Singer prosthesis. Before surgery, he received 6 weeks of external beam radiation to help shrink the cancerous tumor. He has a past history of a kidney stone, which he passed. He had an intravenous pyleography (IVP) 2 months ago. He presents to the outpatient clinic for follow-up. He stated that he...
Joe Clark, a 56-year-old male client, is newly diagnosed with primary hypothyroidism. He is a principal at a local high school. The laboratory results included TSH, 22 mIu/L (normal range: <7 mIu/L); T4, 3.5 mcg/d (normal range: 5 to12 mcg/dL); Total T3, 75 mcg/dL (normal range: 80 to 220 mcg/dL); Free T4 or FT4, 0.5 mcg/dL (normal range: 0.7 to 2.0 mcg/dL); and Free T3, 1.7 mcg/dL (normal range: 2.3 to 4.2 mcg/dL). The vital signs are T, 97° F;...
Joe Dean, a 38-year-old male client, is admitted to the medical–surgical unit with newly diagnosed acquired immunodeficiency syndrome (AIDS) and pneumocystic pneumonia (PCP). He states that he shares needles with other IV drug users. He has had unprotected sexual intercourse with several partners. The client has a nonproductive cough, chills, shortness of breath with exertion, and, at times, chest pain. The vital signs: T, 101°F; BP, 110/70 mm Hg; HR, 100 beats/minute; RR, 28 breaths/minute. The prescriber started the client...
Jane Smith, a 21-year-old client, is admitted with infective endocarditis. The client has a history of mitral valve prolapse and a recent strep throat infection, which she stated when she felt better, she stopped taking the antibiotic. She presents to the telemetry unit with Osler nodes present on the pads of her fingers and toes, and Janeway lesions on the palms of her hands and soles of her feet. She has splinter hemorrhages present on her fingernails. The nurse notes...
Jane Smith, a 21-year-old client, is admitted with infective endocarditis. The client has a history of mitral valve prolapse and a recent strep throat infection, which she stated when she felt better, she stopped taking the antibiotic. She presents to the telemetry unit with Osler nodes present on the pads of her fingers and toes, and Janeway lesions on the palms of her hands and soles of her feet. She has splinter hemorrhages present on her fingernails. The nurse notes...
Case Study, Chapter 51, Caring for Clients With Diabetes Mellitus Candy Sweet, a 56-year-old female client, is recently diagnosed with type 2 diabetes. Both her mother and father had type 2 diabetes around the same age the client developed the disease. She is a secretary for a large firm and lived sedentary lifestyle. She has two children and had gestational diabetes with each pregnancy. The HDL cholesterol is 30 mg/dL and the triglyceride level is 260 mg/dL, which adds to...
April Smith, an 82-year-old female client, is at the independent living facility and had planned on going to a senior outing when she activated her emergency alert button she wears around her neck. When the emergency response system called, she stated in gasping words, “I can’t get my breath!” She denies any chest pain or abdominal pain. The vital signs at the scene were T, 96° F; BP, 190/100 mm Hg; HR, 100 beats/minute; RR, 30 breaths/minute. She is diaphoretic...
April Smith, an 82-year-old female client, is at the independent living facility and had planned on going to a senior outing when she activated her emergency alert button she wears around her neck. When the emergency response system called, she stated in gasping words, “I can’t get my breath!” She denies any chest pain or abdominal pain. The vital signs at the scene were T, 96° F; BP, 190/100 mm Hg; HR, 100 beats/minute; RR, 30 breaths/minute. She is diaphoretic...
Case Study 6 A 23-year-old male presented to the ER with a 5-day history of fever, headache, sore throat, muscle pain, nausea, and diarrhea. He described his headache as a 10/10 on a pain scale and was worsened by bright lights, movement, or noise. He had migraines in the past but stated this felt different. He said there was not a prior history of head injury, chest pain, or ear pain. He does not have abdominal pain, dysuria, or a...
Mr. Smith, a 50-year-old male presents to the office for a comprehensive physical. His blood pressure reading is 162/110 mmHg, with an apical pulse rate of 79 beats/min and regular. He has a history of smoking and drinking six beers per night. He is 5’8" and 230 lbs. Mr. Smith works as a prison guard. He is not previously diabetic but has not had a physical exam since age 25, upon discharge from the military. He has a family history...