Week 9 Case Study DB Response Posts.docx - Case#1 Response...

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Case #1 Response List 5 special considerations of the geriatric patient. o Most older adults take numerous medications for various chronic conditions, which often produce or disrupt metabolic balance. o Thyroid disease presents differently in older patients, with fewer signs of hyperactivity, but pronounced changes in mental status, which can be reflected as apathy, depression, and emaciation. o Atrial fibrillation is common in patients with thyroid disease, especially older patients. o The incidence of diabetes increases with age. o The thyroid in older patients may become fibrotic, causing it to feel more nodular or irregular upon palpation. (Rhoads & Petersen, 2018, p. 354) What laboratory testing would you order for either of these patients and why? o Thyroid-Stimulating Hormone (TSH) – it is believed that circulating level of TSH is the single most sensitive test of thyroid function (Rhoads & Petersen, 2018, p. 351). Decreased levels of TSH are found in patients with Graves’ disease and toxic nodular goiter (Rhoads & Petersen, 2018, p. 351). Increased levels of TSH are found in patients with primary hypothyroidism and thyrotoxicosis due to pituitary tumor (Rhoads & Petersen, 2018, p. 351).

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