Question

Valarie Ramirez, a 33-year-old female, arrives at the clinic for a follow-up check for the removal of a painful wart on her right hand. During the patient interview, she states that she is not having trouble with her hand; however, she has noticed in the mirror that she has a lump on the front of her neck at the bottom. She is a little hoarse but denies any other symptoms. She thought she should tell the doctor. Her vital signs are BP 122/78 T 98.8 P 88 R 20 Ht. 5′ 2″ Wt. 135 lb. Dr. Buckwalter orders an ultrasound of the lump with needle biopsy if indicated. He also orders blood work, including TSH and CEA tests.

Discussion Questions: p. 866

1. How would you chart Valarie’s chief complaint?

2. The physician thinks Valarie has a thyroid nodule that may be cancerous. Which two types of specialists might she need to visit?

3. Based on the results of the ultrasound, the physician wants to evaluate the thyroid nodule by performing a needle biopsy. What will your responsibilities be during this procedure?

NOTE: please answer all 3 questions separately. Thank you!

Answer 1

1.Valerie's complaints should be recorded everything .Collect subjectively data, and do physical examination for objective data , list the complaint's of Valarie in head to toe manner. Record every thing when the symptoms started date and time , whether symptoms increase or decease, any allergies. Record vitals with time . Height:5"2. Weight 135 lb. Temp 98.8 °f. Pulse : 88BPM. Resp : 20 breaths/min Blood pressure:122/78. Complaint :Painfull wart on right hand. , nodule on neck.

2.To proceed with any treatment first she need to consultant with Endocrinologist for confirmative diagnosis as Thyroid and oncologist to Co form weather it was cancareoua or not.

3.Nursing responsibilities in Needle biopsy: *Nurses responsibilities included preparing and educating the patient, assessing for complications , supporting patient during procedure and assisting the practitioner. *Reinforce the procedure's purpose with the patient. *Explain patient that that will feel little discomfort during procedure. *Make sure patient gave informed consent. *Assess for bleeding risk ,review history of any coagulation disorders. *Help patient to be in appropriate position. *Arrange necessary equipment for procedure. *After aspiration ,apply direct pressure over the puncture site. *Help the patient to a comfortable position. *Don't leave the patient unattended during procedure. *Dont administer analgesics containing aspirin.