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MedSurg- Endocrine IIkaitlyn

MedSurg- Endocrine IIkaitlyn

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Published by simonedarling

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Published by: simonedarling on Oct 26, 2009
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12/31/2012

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Endocrine Topics IIHyperthyroidism Thyroid Storm Thyroidectomy Thyroid medical treatmentsHypothyroidismHypercortisolism/ Cushing's/Steroid useAdrenal insufficiency/ Adrenalcrisis
Case Study 1
Mrs. Taylor is a 32 year old thin,anxious woman brought in by her even more concerned husband. Sheis diaphoretic, tremulous, moves
 
continuously in bed, is havingdifficulty breathing and complainingof feeling warm. She tells us “her heart is pounding.” Over the past 2weeks, she has been unable to sleep,she has lost 7 lbs, and her heart hasbeen “pounding” at times, even at rest. She said she had been told “shemight have a thyroid problem” 
What are you concerned about? Whatshould you anticipate and assess?-HR “pounding”- Labs: Thyroid T3 and T4, TSH
- Blood Pressure: anticipate ahigh systolic and decreaseddiastolic- Temperature- EKG- check if she hasdysrhythmias
 
- look at thyroid/ hesitant topalpate because can causemore spilling of thyroidhormone- assess her skin and hair:silky hair; moist, warm skin- ask about wt. Loss- look for exopthalmos- r/o cardiac problems withasking questions about thechest pain and if any of thosepoint towards MI then getenzymes CK-MB- get blood glucose andanticipate hyperglycemiabecause hyperthyroidismincreases glucose intolerance

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