Question

Ms. S is a 64 year-old retiree who was admitted to the hospital for an emergency splenectomy following a fall. Her medical history includes: Type II diabetes for the past 10 years, hypothyroidism, atrial fibrillation, and obesity. Until her fall, she had not had any problems related to her spleen. Her mother was also a diabetic and all of her siblings have atrial fibrillation. Medications: Synthroid, Metformin, atenolol, and a baby aspirin a day.

It is now three days post op and the large abdominal wound from her surgery is red and draining yellow drainage. Her vital signs are 145/80; HR-90, R-20, T-100.8 F. In your concept/patho map be sure to include all the steps from the risk factors to the development of the diseases or problems following her splenectomy. The more details you can provide the better.

Here are the areas to be sure to include in your concept map:

> Splenectomy: relationship among splenectomy and infectious processes; impact on red blood cells and oxygenation; stress related to surgery; impact on blood glucose.

> Hypothyroidism: impact on cardiac system; blood glucose, skin, immunity, tissue perfusion

> Diabetes: relationship among obesity, insulin resistance, changes in vessels, circulation, WBCs, relationship between blood glucose and pathogens

> Atrial fibrillation: what happens to cardiac output, WBCs, oxygenation of tissues, impact on infection > Systems connectivity: indicate all relationships between and among the various systems

Answer 1

Does hypothyroid and diabetes -11 are related to each other , studies has not yet proven but yet they could be as they are both in endocrine system related to each other closely .

As by age , the organs slows down in their production of hormones , like in hypothyroid –less thyroxin is produced with the side effects of lethargy , weight gain, Fatigue, Sensitivity to cold , Constipation, Dry skin, Weight gain, Puffy face, Hoarseness, Muscle weakness, Elevated cholesterol level, Muscle aches, stiffness, and tenderness, Pain, stiffness, swelling in joints, Heavier and/or irregular menstrual periods, Thinning hair, Slowed heart rate, Depression, Impaired memory.

Thyroid function has an effect on diabetes due to its role in regulating the body’s metabolism. The symptom’s can worsen many diabetic conditions, such as neuropathy.

Blood glucose is affected by high thyroid levels or low thyroid levels. When there is hypothyroidism, the insulin is used up slower, so your blood glucose could drop low. Your thyroid does play an important role in maintaining regular blood glucose and insulin levels.

# Thyroid hormone influences the force and speed of heartbeat, blood pressure, cholesterol level .Increase in cholesterol directly shrinks the arterial wall causing increase blood pressure and increase heart to work to pump blood thereby increasing the heart rate and poor heart rate .

# diabetes -11 can cause heart problems .

Patients with diabetes -2 has insulin resistance can lead to anthrogenic lipidemia , with high cholesterol , leading to heart disease , high blood pressure leading to ischemia of heart .

# due to ageing , diabetes -2 the patient is over weight risking heart disease and delayed prognosis with diabetes -3.

# hypothyroidism can cause skin dryness , itchiness and skin scratches which can delay in wound healing of increased blood glucose level .

#low libidio and menstrual problems in reproductive system .

#spllenectomy can affect the platelet level which could shoot up immediatiely after surgery –thromobocytosis .

#increased chance of infection( T cells are absent to remember the invaded bacteria and pthogens )

#the RBC are recycled in spleen , the cells will not be cleaned after 120days cycle, affecting the oxygenation level

# less oxygenation causing the heart to pump more blood there by increase cardiac work .

hope the answer helps :)