In: Nursing
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.