CONDE, ANTONETTE Q.

BSN4 BLK6

Jan9, 2023

NCM118 N036

Assessment and Management of Patients with Endocrine Disorders (Pt 1)

Pre-assessment Quiz

True or False: Write T if the statement is True and F if the statement is False
1. The major function of the parathyroid hormone is the regulation of serum calcium. TRUE
2. Iodine is essential to the thyroid gland for the synthesis of its hormones.TRUE
3. Extreme fatigue, hair loss, brittle nails, and dry skin are common clinical manifestations of hyperthyroidism. FALSE
4. Thyroidectomy is the treatment of choice for thyroid cancer. TRUE
5. An acute hypercalcemic crisis occurs with extreme elevation of serum calcium levels and can be life threatening. TRUE

Fill-in-the-Blank. Read each statement carefully then write the best response on the space provided.
1. The major action of the HYPOTHALAMUS is controlling the release of pituitary hormones.
2. GOITER is an enlargement of the thyroid gland that commonly occurs with iodine deficiency.
3. GRAVES disease, an autoimmune disorder, is the most common cause of hyperthyroidism.
4. Following thyroid surgery, the patient should be monitored closely for signs of TETANY, an indicator of a disturbance in
calcium metabolism due to injury or removal of the parathyroid gland.
5. THYROID STORM severe life-threatening hyperthyroidism precipitated by stress that is characterized by high fever, extreme
tachycardia, and altered mental state

CASE STUDY:

Patient Profile: Danilo, 58 years of age presents to the family physician to follow up on some symptoms he recently developed.
The patient states that he is extremely tired and is having trouble concentrating. He states that his skin is dry and flaky. His nails
are brittle and his hair is dry, dull, and falls out as he showers. He is 8 weeks postop after a modified radical neck procedure for
laryngeal cancer and has completed the external radiation therapy. He is using a Blom--Singer prosthesis for speech. He states
that his appetite is poor, yet he is gaining weight. The patient’s current medications include metformin (Glucophage) for a
history of type 2 diabetes, digoxin 0.25 mg every day for a history of atrial fibrillation, and warfarin therapy being managed by
the family physician for thromboembolism prophylaxis related to atrial fibrillation. The physician orders the following lab work:
CBC with differential, serum albumin, Thyroid Stimulating Hormone (TSH), Free thyroxine (FT4), Prothrombin Time (PT), and
(International Normalized Ratio) INR.
1. The physician diagnosed the patient as having hypothyroidism. What are the reasons why the patient developed
hypothyroidism? The patient previously received external radiation for laryngeal cancer, which could inhibit the
function of the thyroid, thus causing hypothyroidism.

2. Based on the results of the TSH and FT4, the physician starts the patient on levothyroxine (Synthroid) 0.025 mg/day
and to have follow-up TSH and FT4 labs and a visit to the oncologist in 4 weeks. The physician informs the patient that
he will continue to have lab tests and monthly follow-up until the TSH and FT4 are stable. What is the rationale for this
treatment plan? In order for the physician to ensure that the clients TSH and FT4 are within the normal range and
that the medication is working, the patient will need to come in for routine bloodwork.

3. What nursing interventions should the nurse provide the patient? The nurse should monitor the patient’s lab values,
assess for signs and symptoms of hypothyroidism, and ensure that his condition is improving following his new
medication regimen. The nurse should also provide education on Synthroid and why the medication is being
prescribed.