UST GRADUATE SCHOOL

ADVANCED MEDICAL-SURGICAL NURSING 1

AY 2014-2015
ASSOC. PROF. I.S.TIONKO

CASE SCENARIO- ENDOCRINE PROBLEMS

A 66 y/o, female client, widow and lives alone is recovering slowly from a bout of
pneumonia. When her daughter arrived to check up on her, she was found on bed
complaining of weakness, constant fatigue, and abdominal discomfort. She states she
cannot see well, is always thirsty and has been going to the bathroom more than usual
and has had the feeling of gastric fullness for sometime. She is brought to the hospital
for a diagnostic work up. History reveals she underwent subtotal Thyroidectomy 3 years
ago for Hyperthyroidism. Family history reveals that her parents are both type II
diabetics. Physical examination revealed the ff: BP 168/94, T-99.0 F, P-90, R-20; deep
rapid respirations with fruity odor of the breath; bilateral ronchi; skin is warm; dry and
cracked with poor turgor; small reddened area of great toe of right foot; claudications
and numbness of the extremities; eye exam reveals several small microaneurysms.
Diagnostic tests reveal; ABG: pH-7.25; PCO2-30, HCO3-15; Hct. and BUN elevated;
serum glucose-420 mg/dl; glycosylated Hgb 7.5%
INSTRUCTIONS:
1. Identify the learning issues (at least 7) related to pathophysiology (Focus on Endocrine) that
you can draw out from this case.
2. Prepare to discuss these learning issues with the class on Tuesday, October 7, 2014 after the
Neuro case scenario discussion.
3. From your journal readings, what can you draw out as an identified controversial issue on
pathophysiology related to endocrine problems? Provide a short discussion based on your
journal resources.
3. Your written answer to # 1 & 3 will be submitted on October 14, 2014, Typed in A4 size, arial
narrow, font 11.