VIRTUAL CLINICAL DUTY

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STUDENT NURSES’ NAME Shamsa Hynra P. Afdal

YEAR / SECTION / GROUP 3 / NB / Group 1
SCHOOL ID NUMBER 201131190
CONTACT NUMBER 0955 975 5831
OFFICIAL EMAIL ADD 201131190@my.xu.edu.ph
HOSPITALS’ NAME JR Borja General Hospital
AREA OF DUTY Medical Ward
SHIFT PM Shift
DATE / DAY February 10-11, 2021
CLINICAL INSTRUCTOR Mr. Joseph Bahian Abang, AHSE, BSN,
RN, MN, MAN

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CRITICAL THINKING QUESTIONS

1. Compare her VS with those of a healthy person at her same age.

Patient GH is a 38 year old woman. Her vital signs showed: BP of 142/82
mmHg, HR of 52 bpm, RR of 12 bpm, and a temperature of 36˚ C.
Compared the people at her age her respiratory and temperature are within
the normal range. However, for an average healthy adult the normal blood
pressure is within 90/60 mmHg to 120/80 mmHg, and the normal pulse rate
is 60 to 100 beats per minute. The blood pressure of patient GH is above
normal and her heart rate is below normal.
2. List eight general questions you might ask G.H to assist in determining what is
going on with her.
o Do you have any family member or relative that has a thyroid disease?
o Are you currently on a hyperthyroidism treatment?
o Did you recently have a radiation therapy? Can you specify where?
o What is your usual diet intake?
o How is your appetite lately?
o Do you get easily cold lately?
o During your menstrual cycle, was there any alterations?
o Do you have any history of any autoimmune disease?
3. Unnecessary diagnostic tests are expensive. What test do you think would be the
most appropriate for GH and why?
The most appropriate diagnostic test for patient GH is blood test that
specifically measure the TSH and thyroxine hormone levels. An indication
of hypothyroidism would present a result of low level of thyroxine hormone
and a high level of TSH, this is due to the effort of the pituitary in produce
more TSH to stimulate the thyroid gland in producing more thyroid hormone.
4. Interpret GH laboratory results.
Patient GH laboratory results showed a high level of TSH and TRH, this
signifies presence underactive thyroid or hypothyroidism since the pituitary
glands are producing more TSH to stimulate the thyroid gland to produce

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hormones. A more indicative of hypothyroidism lab result is the low T3 and
free T4 of the patient, this means that the patient’s thyroid gland is producing
hormones lesser than normal.
5. Why would you want to obtain a complete drug history on GH.
A complete drug history on patient GH is important since one of the
precipitating factors of hypothyroidism is drug induced. If the patient is
currently having hyperthyroidism therapy, the cause of her hypothyroidism
could be over-response to her treatment. Other medications such as,
amiodarone, lithium, interferon alpha, and interleukin-2 are drug that
prevent the thyroid gland from functioning normally.

References

American Thyroid Association. (2020, June 8). Hypothyroidism.

https://www.thyroid.org/hypothyroidism/

Hypothyroidism - Diagnosis and treatment - Mayo Clinic. (2020, November 19). Mayo

Clinic. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-

treatment/drc-20350289