Reference no: EM133844193
Case Study: The patient with Hypothyroidism
Jane Lee is a 80-year-old retired nurse living with her husband, also 80 in a single family home. The Lees are a fairly active couple for their age. Both still drive and volunteer at the local hospital. Mrs. Lee has gained 10 lb (4.5 kg) in the past few months, even though she is rarely hungry and eats much less than normal. She is always tired and weak-so tired that she has not even been able to get out of bed without great effort and has been unable to do housework. She is concerned about her appearance and the way she sounds when she talks. Her face is puffy, and her tongue always feels thick. Mr. Lee convinces his wife to make an appointment with her MD.
ASSESSMENT
Brian Henning, RN, completes the health assessment for Mrs. Lee at the health center.He finds that she now weighs 150 lb (68 kg), an increase of 10 lb (4.5 kg) over her weight at her last visit 6 months earlier. Mrs. Lee states that she always feels cold, tired, and weak. She also states that she is constipated, has difficulty remembering things, and looks different. Physical assessment findings include a palpable and bilaterally enlarged thyroid; dry, yellowish skin; nonpitting edema of the face and lower legs;
and slow, slurred speech. Diagnostic tests revealed the following abnormal findings: T3, 56 ng/dL (normal range: 80 to 200 ng/dL); T4, 3.1 (normal range: 5 to 12 mg/dL); TSH increased. The medical diagnosis of hypothyroidism is made, and Mrs. Lee is started on levothyroxine 0.05 mg daily.
2. Describe the factors that put Mrs. Lee's safety at risk. Thinking about what the Lees home might look like, what alterations in her home environment would you suggest to promote safety until the prescribed medication takes effect?
3. The client taking oral thyroid medication should be able to live a normal life without complication. What would you include in a teaching plan for Mrs. Lee to look for to signal that the thyroid medication is working? What manifestations would you teach Mrs. Lee to look for that might signal too much medication?