Trisha May L.

Matillano BSN4 B

Follicular Neoplasm (Thyroid Tumor/Cancer)

Definition:
Thyroid cancer develops when cells genetically mutate or change. The abnormal
cells begin multiplying in your thyroid and, once there are enough of them, they
form a tumor.

Signs and Symptoms of Thyroid Cancer

Thyroid cancer can cause any of the following signs or symptoms:
 A lump in the neck, sometimes growing quickly
 Swelling in the neck
 Pain in the front of the neck, sometimes going up to the ears
 Hoarseness or other voice changes that do not go away
 Trouble swallowing
 Trouble breathing
 A constant cough that is not due to a cold

What Causes It?

There is no clear reason why most people get thyroid cancer. There are certain
things, though, that can raise your odds of getting it.

Inherited genetic syndromes.Some conditions, including cancer, come from the

DNA you get from your parents. In eight out of 10 cases of medullary thyroid
cancer, for example, the cancer is a result of an abnormal gene you’ve inherited.
Iodine deficiency. If you don’t get much of this chemical element in your diet,
you could be at more risk for certain types of thyroid cancer. This is rare in the
United States because iodine is added to salt and other foods.
Radiation exposure. If your head or neck is exposed to radiation as a child, or if
you have too many X-rays, for example, you may have a higher chance of getting
it.

Who Gets It?

Thyroid cancer is more common in women than men. Women tend to get thyroid
cancer in their 40s and 50s, while men who get it are usually in their 60s or 70s.
Follicular thyroid cancer mostly happens to people who are over 50. Anaplastic
thyroid cancer usually happens after 60.
You can still get thyroid cancer if you’re younger. Papillary thyroid cancer, for
example, happens most often in people between ages 30 and 50.

Is It Treatable?
Thyroid cancer is usually very treatable, even if you have a more advanced stage
of it. That’s because there are effective treatments that give you a great chance for
a full recovery. And surgery, when it’s needed, can sometimes cure it.

Source: https://www.webmd.com/cancer/what-is-thyroid-cancer

Chronic fatigue syndrome: Does the thyroid play a role?

Date: March 20, 2018

New research demonstrates a link between chronic fatigue syndrome

(CFS) symptoms and lower thyroid hormone levels. Published in Frontiers in
Endocrinology, the study indicates that CFS, a condition with unknown causes,
can be explained by lower thyroid hormones -- but may be distinct from thyroidal
disease. This finding can be seen as a first step to finding treatment for a
debilitating illness for which there is no recognized treatment.

Chronic fatigue syndrome is a common disease marked by lengthy spells

of weakness, fatigue and depression. Its diagnosis is predominantly based on
symptoms and on ruling out any underlying medical condition, rather than on
laboratory tests and physical examination.

Interestingly, several symptoms resemble those of hypothyroidism -- a

condition where the thyroid gland does not produce enough thyroid hormone. In
hypothyroidism, the body tries to encourage thyroid hormone activity by releasing
more thyroid-stimulating hormone -- however, this does not happen in patients
with chronic fatigue syndrome.

This contrast in thyroid-stimulating activity led the study's authors to

hypothesize that chronic fatigue syndrome is caused by low activity of thyroid
hormones in the absence of thyroidal disease.

Led by Dr. Begoña Ruiz-Núñez at the University Medical Center

Groningen, The Netherlands, the researchers compared thyroid function and
markers of inflammation between 98 CFS patients and 99 healthy controls.
Remarkably, the CFS patients had lower serum levels of certain key thyroid
hormones such as triiodothyronine (T3) and thyroxine (T4), but normal levels of
thyroid-stimulating hormone.

Additional analyses indicated that CFS patients had a lower urinary

iodine status and low-grade inflammation, which possibly mirrored the symptoms
of patients with hypothyroidism. These CFS patients, however, had relatively
higher levels of another thyroid hormone called "reverse T3" or rT3. This
appeared to be due to a shift in hormone production, where the body preferred to
convert T4 to rT3 instead of producing T3. The low T3 levels found in CFS
patients coupled with this switchover to rT3 could mean that T3 levels are
severely reduced in tissue.

"One of the key elements of our study is that our observations persisted in
the face of two sensitivity analyses to check the strength of the association
between CFS and thyroid parameters and low-grade inflammation," says Dr.
Ruiz-Núñez. "This strengthens our test results considerably."

The researchers believe inclusion of patient information, such as duration

of illness, would enable a correlation with their biochemical profiles. Further,
even though the study demonstrates a link between chronic fatigue syndrome
symptoms and low levels of key thyroid hormones, a definitive cause for CFS
remains unknown.

If the study findings are confirmed by additional research, it may pave the
way for a treatment for chronic fatigue syndrome.

Summary:

A new study reveals that chronic fatigue syndrome, a debilitating condition with
unknown causes, can be explained by lower thyroid levels -- but may be distinct from
thyroidal disease. This can be seen as a first step to finding a treatment for a common
illness for which diagnosis is hard to come by.

Journal Reference: Begoña Ruiz-Núñez, Rabab Tarasse, Emar F. Vogelaar, D. A.

Janneke Dijck-Brouwer, Frits A. J. Muskiet. Higher Prevalence of “Low T3
Syndrome” in Patients With Chronic Fatigue Syndrome: A Case–Control Study.
Frontiers in Endocrinology, 2018

Source: https://www.sciencedaily.com/releases/2018/03/180320084337.htm
Patient:L.E. Age: 38 years old Diagnosis: Follicular Neoplasm

ASSESSMENT DIAGNOSIS RATIONALE EXPECTED NURSING RATIONALE EVALUATION

OUTCOME INTERVENTION
Predisposing Precipitaing
Subjective cues: Imbalanced Nutrition: Short term goals: 1. Emphasize the To gain patients full
factors: Factors:
Patient verbalized, Less Than Body After 5-6 hours of need cooperation.
"Medyo budlay Requirements r/t nurse-patient to eat meals with
magkaon kay sakit difficulty in 38 years old Low-socio interaction, patient adequate nutrition
mag swallowing economic will and
Female status
tulon, biskan tubig be able to: how it will benefit
sakit man." (+) Family Fatigue her
Definition: history health regarding her
Intake of nutrients Show understanding current condition.
Objective cues: insufficient to meet of
Facial grimace is metabolic needs. ↓ significance 2. Provide a pleasant To help in decreasing
observed when nutrition to healing environment. stress and is more
patient Damage and failure of process and general favorable to eating.
is swallowing repair DNA health.
↓
Vital Signs: Mutation in genome
T- 36.9 掳 C ↓ Identify interventions 3. Provide good oral To enhances appetite;
Alteration in genes that will enable hygiene and the condition of the
PR-98 bpm that regulate apoptosis adequate food intake dentition.
RR- 18 com oral mucosa is critical
↓ per orem. to the ability to eat.
BP-130/100 mmHg Decreased apoptosis Also, good oral
 (normal cell death) hygiene
Strength: ↓ will prevent risk for
Strong family Colonial expansion infection.
support ↓
Cooperative Tumor progression
↓
Growth of neck mass
Weakness: ↓
Deficient knowledge Removal of mass
Financially unstable (Total Thyroidectomy)
↓
Post-operative wound
↓ 4. Encourage small
Inflammatory To ensure patients
frequent feeding, comfort, at the same
response incase patient is not
↓ time providing
able to tolerate the adequate nutrition. To
Signs and Symptoms: pain. Avoid serving avoid further injury.
Redness, pain, and food hot, as well as
swelling in the avoid spicy food.
surgical
area (neck area)
5. Provide food that
↓
is
Difficulty in To allow client to eat
easy to swallow (like
swallowing food with ease and
soup) and favorable
to the patient. good appetite. Reduce
Instruct to chew well and prevent aspiration.
and eat slowly.