Reference no: EM133857346

Assignment:

Nurses are being called upon to fill primary care roles and to help patients manage chronic illnesses, thereby preventing acute care episodes and disease progression. They are expected to use a variety of technological tools and complex information management systems that require skills in analysis and synthesis to improve the quality and effectiveness of care. Across settings, nurses are being called upon to coordinate care and collaborate with a variety of health professionals, including physicians, social workers, physical and occupational therapists, and pharmacists, most of whom hold master's or doctoral degrees. Shortages of nurses in the positions of primary care providers, faculty, and researchers continue to be a barrier to advancing the profession and improving the delivery of care to patients. To respond to these demands of an evolving health care system and meet the changing needs of patients, nurses must achieve higher levels of education and training.

1. What is the significance of the thyroid-releasing horomone (TRH) test in differentiating various causes of hypothyroidism?

2. Is retention of urine/incomplete voiding related to hypothyroidism? If so, how?

3. It is stated that a little overtreatment might be required for hypothyroidism, i.e. slightly raised thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). Is the clinical improvement the best criteria or is there an optimum/maximum level that one should watch out for when monitoring TSH and T4?

4. Why is thyroid-stimulating hormone (TSH) normal or increased in patients with peripheral resistance to tri-iodothyronine (T3) and thyroxine (T4)? The thyroid hormone levels are high in these patients, so the TSH should drop lower: why doesn't it?

5. Thyroxine is a peptide hormone used to treat thyroid deficiency and other thyroid disorders. It is taken orally. Peptides are broken down into amino acids before being absorbed. What factors cause the thyroxine to remain stable in the digestive tract so that it is absorbed without being digested?

6. 1. Does the absence of bradycardia exclude hypothyroidism?

2. How often is hypothyroidism accompanied by bradycardia?

7. Should patients with hypo- or hyperthyroidism be given iodine supplements?

8. Is Hashimoto's thyroiditis associated with dementia?

9. Please explain the causes of, and suggest recommended treatments for, euthyroid and hypothyroid states.

10. What is the role of propranolol in the management of a 35-year-old male thyrotoxic patient who is also hypertensive?