Reference no: EM133895072

Question

NURSING DIAGNOSIS, PLANNING/OUTCOME, INTEVENTIONS, RATIONALE FOR INTERVENTION, EVALUATION/REPLANINING.

Mrs. Juanita Manuel is a 33-year-old mother of four small children. She is a second-year student at the local community college, within one semester of completing the requirements for an associate degree in childcare. For the past 3 months, Juanita has been constantly hungry and has eaten more than usual, but she has still lost 15 lb (6.8 kg). She has repeated bouts of diarrhea and often feels nauseated. Her hands shake, she can feel her heart beating rapidly, and she finds herself laughing or crying for no apparent reason. Mrs. Manuel makes an appointment with her family physician. The nurse at the office completes a health history and physical assessment. When asked how she has been feeling, Mrs. Manuel replies,"Well, I don't know what's wrong with me-but I keep losing weight and I cry at the drop of a hat. I am also just so hot all the time, and I've never had that problem before. I hope I find out what's wrong and it's nothing serious."

The health history indicates that although her appetite has increased, Mrs. Manuel has lost 15 lb (6.8 kg). She states that she has had diarrhea, nausea, palpitations, heat intolerance, and mood changes.

Physical assessment findings include the following: T 101°F (38.3°C), P 110, R 24, and BP 162/86. Her skin is moist and warm, her hair thin and fine. She has visible tremors in her hands. Her eyeballs protrude, and she is unable to close her eyelids completely. Her thyroid is enlarged and palpable. Diagnostic tests reveal the following abnormal results: T3, 350 g/dL (normal range: 80 to 200 ng/dL), T4, 15.1 mg/dL (normal range: 5 to 12 mg/dL). A thyroid scan demonstrates an enlarged thyroid with increased iodine uptake.

After the medical diagnosis of Graves' disease is made, Mrs. Manuel is started on the antithyroid medication propylthiouracil, 150 mg orally every 8 hours.

Develop a plan of care for Ms. Adamson.