Mrs. Duarte is a 40-year-old female who has scheduled an appointment with her PCP to assess...

Mrs. Duarte is a 40-year-old female who has scheduled an appointment with her PCP to assess a lump that has developed on the left side of her neck.

Mrs. Duarte explains to her PCP that she has noticed a swollen area on the left side of her neck that has been increasing in size. She states, “I am really afraid I have cancer. I eat plenty of food, but seem to be losing weight. I have lost 10 lbs in less than 2 months. I have been very agitated and irritable. Perhaps I am nervous about the possibility that this lump is cancer.” Her VS include BP 142/64, HR 128, RR 24, and temperature 98.8 degrees F. The PCP notes that Mrs. Duarte’s hands have a fine tremor, and she has mild periorbital edema indicative of exophthalmos. On physical assessment, the PCP palpates a smooth, soft, enlarged left lobe of the thyroid gland. The PCP places the bell of the stethoscope over the swollen area and auscultates a bruit. Further discussion reveals that Mrs. Duarte has been having difficulty sleeping, thinning hair, and loose bowel movements. Concerned about a thyroid disorder, the PCP prescribes serum laboratory testing to assess the client’s level of TSH, T3 & T4, and schedules the client for a radioactive iodine uptake test.

Does the PCP suspect that Mrs. Duarte has hypo or hyperthyroidism? Identify the clinical manifestations that support your answer.

Identify 3 nursing diagnoses appropriate for Mrs. Duarte. Indicate which of the 3 diagnoses would be the priority nursing diagnosis and provide your rationale – include nursing diagnosis, related to (r/t), and as evidenced by (AEB) statements.

What do you suspect Mrs. Duarte’s findings will reveal for her lab and diagnostic tests – indicate increase, decrease, or results for TSH, T3, T4, and radioactive iodine uptake test.

Mrs. Duarte develops hypothyroidism following her radioactive iodine therapy. Her PCP prescribes levothyroxine. She asks the nurse, “What is this medication for and how long will I need to take it?” Provide the patient with teaching regarding the rationale for the prescribed medication & respond to her question regarding the length of treatment needed. Also, include 3 other teaching points you would want to educate the patient on regarding this medication.

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Nightingale answered 8 months ago

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