Case Study: Hypo Thyroid Disease – Myxedema Jeanine has been dieting and exercise and trying unsuccessfully to lose weight. Her nutrition counselor suggests that Jeanine to her physician. Whenever a person is overweight they may ask the physician the question, “Do I have low thyroid function?” (I hope) because it is much easier to take a pill to lose weight and regain energy than it is to tackle the alternative of diet and exercise. List the symptoms of low thyroid function. Swelling of lips and eyelids, dry thick skin, bruising, thin coarse hair, hoarseness, generalized non pitting edema, facial edema, may seem slow, depressed or apathetic. What tests will confirm the diagnosis? Free T4 and TSH List the drugs and explain the action of medication given to treat hypothyroid disease. Thyroid hormone replacement drugs (synthroid) increases the metabolic rate. How will blood tests be used to follow and evaluate the effect of medication? Jeanine for life adjustment with hypothyroid disease? Blood can be tested every 6 weeks or so to make sure the levels are where they need to be, if not then medication dosage can be adjusted. What will precipitate a Myxedema coma? Severe untreated hypothyroidism can progress into myxedema. Infection, trauma, excessive chilling, and some drugs may precipitate a myxedema coma. Case Study Continued: Hypo Parathyroid Disease During a postoperative checkup Shirley demonstrates a positive Chvosteck’s sign. The physician next tests for Trousseau’s sign, and then orders a bone scan.
Endocrine Case Studies How did Shirley develop hypoparathyroid disease? Her parathyroid glands were removed or damaged during surgery Explain Chvosteck and Trusseau’s signs. Chvosteck: spasm of facial muscle when facial nerve tapped. Trusseau’s: carpopedal spasm when a BP cuff is inflated above the patients systolic BP and left in place for 2-3 minutes. Why did the physician order a bone scan? Because of the decrease in the serum calcium level. The physician may require Shirley to wear a Holter Monitor because….? To make sure there is no dysrhythmias and HF. What is the function of parathyroid hormone? How is this related to calcium? Plays a critical role in regulating the serum calcium level. PTH increases the absorption of calcium from the intestines, transfers calcium from the bones to the blood, and signals the kidneys to conserve calcium. List blood studies the physician will use to follow parathyroid function. Calcium, phosphate, creatinine, uric acid, magnesium, alkaline, phosphatase, PTH, parathyroid, antibodies What is the purpose of Shirley taking Vitamin D and Phosphate-binding drugs? Promotes calcium absorption from digestive tract. Describe patient teaching needed when taking Phosphate-binding drugs . Carry medical ID cards, know signs and symptoms of calcium imbalances, teach self medication.
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- Spring '19
- Alycia Combs