Reference no: EM133870791
L.R. is a 35 year old female patient who is being seen for a post-op exam following a partial thyroidectomy 1 month ago. The patient had developed a benign nodule on her thyroid that continued to grow and was starting to affect her swallowing abilities. She underwent a partial thyroidectomy 4 weeks ago and had an uncomplicated recovery. At the follow-up exam, L.R. complains of feeling extremely tired and says that she never was able to return to the same state of activity she had before her surgery. Sometimes, she has difficulty getting out of bed. She has gained 5 lbs since her surgery and she complains of feeling cold all the time. She often has muscle aches and joint pain, for which she takes acetaminophen for pain relief. Her vital signs are HR 60BPM, RR 12/min, BP 110/70mmHg, T98.0º F.
1. The patient is most likely suffering from hypothyroidism as a result of her thyroidectomy. Explain how removal of part of the thyroid gland would cause the patient's symptoms.
2. Describe the major roles of T3, T4 and TSH in the body.
The physician gives orders for L.R. to have a TSH level drawn at the lab and the results are 8.6mIU/L. The physician then orders levothyroxine 75mcg po daily because of the patient's thyroid hormone levels. The nurse gives the client a prescription for the medication and provides teaching about what to expect when taking it.
3. How does levothyroxine work in the treatment of hypothyroidism?
4. What signs or symptoms should the nurse tell the client to look for that would be side effects of using levothyroxine?
5. Does the patient need to take this medication every day? Why or why not?
The nurse sets up an appointment for L.R. to return to the clinic in one month after she has had a chance to take the medication and to recheck her thyroid hormone levels. The patient is also instructed about the complications of untreated hypothyroidism.
6. What type of complications could this patient develop if she does not take her thyroid supplement?
7. What is myxedema? How does this condition develop as a result of untreated hypothyroidism?
8. What is a goiter? How would a goiter be treated if the patient were to develop this condition?