Question

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.

Explain the reason for the thyroid panel and what comprises it, and what should the nurse predict the lab values will do in this case.

Answer 1

Patient history - bradycardia, hypothermia, hypotension,dry skin , alopecia, periorbital edema

Indicate hypothyroidism condition

After surgery due to iatrogenic damage to thyroid or radiation damage

Lab values predict as - low T3 and T4 level ,low thyroxin

Higher leve of TSH( thyroid stimulating hormone)