Question

Crystal Acton, a 27-year-old married woman, pregnant with her first child, presents at the OB/GYN clinic for her first prenatal visit. The nurse-midwife begins her assessment of this patient by documenting a medical and family history.

Mrs. Acton states that the only medication she is taking is a multivitamin with folic acid daily. She has no family history of breast, ovarian, or vaginal cancer.
While performing the physical assessment, the nurse-midwife notes a thrill over the thyroid gland, which feels markedly enlarged. Auscultation confirms a bruit in the thyroid area.

Documentation includes the following: Head WNL; submental and submandibular lymph nodes hard and enlarged; thyroid gland markedly enlarged, thrill palpated, bruit auscultated.
The nurse prepares a teaching plan for this patient.

1. What risks involving the head and neck are addressed by assessment documentation? In other words, what is it about her assessment that concerns you? What are the abnormalities? Which conditions would the patient be at risk for, based on these findings? Explain your train of thought here.

2. What diagnostics would the nurse-midwife expect from her assessment discoveries?

3. How would the nurse-midwife proceed in light of her assessment data?

Answer 1

HEALTH EDUCATION:

FINDING : Patient is have Thrill over the thyroid gland and noticed enlarged thyroid and bruit asucultated while examining.

SYMPTOMS

Goiter Symptoms Healthy Thyroid Goiter

EFFECT ON MOTHER AND FETUS

Effect of hyperthyroidism, ON PREGNANCY ON FETUS Spontaneous abortion, Preterm birth, Pre-eclampsia, Abruption, Fetal growth restriction, Perinatal morbidity and mortality, Congestive heart failure, Thyroid storm. Congenital malformations of heart, kidney or brain. Fetal Graves' disease fetal tachycardia, high output cardiac failure, NIHF, craniosynostosis, LBW, fetal goiter, Fetal demise.

Symptoms of Postpartum Thyroiditis Hair loss Decreased milk volume in breastfeeding women Painless goiter Fatigue Depression, anxiety and moodiness

Reduce Your Risk of Thyroid Disease Eat less soy Quit smoking Request thyroid collar during X-rays Consider supplements POTASUM TOOTDE Sanium

• Spontaneous abortion/stillbirth . Congenital anomalies • Endemic cretinism Fetus Neonate • Hypothyroidsim • Mental retardation • Increased mortality Child and Adolescent • Goiter • Hypothyroidsim • Neurocognitive defects • Impaired physical development • Lower intelligence quotient

Patient is at risk of goiter disease based on her findings.