Case Study 79 - Hyperthroidism & Graves Disease

Case Study 79 – Hyperthyroidism and Grave’s Disease 1. Which of K.B.'s assessment findings represent manifestations of hypermetabolism? He has a high pulse rate of 124, which means he is tachycardic. He has a high temperature of 100.2F, which means he is running a fever. He is experiencing feelings of anxiety, insomnia and restlessness. 2. Interpret K.B.'s laboratory results. His Hgb (11.8g/dL) and Hct (36%) are both low which is a result from a hypermetabolic state. His ESR is elevated at 48mm/hr. which could indicate an infection or necrosis of the tissues. His BUN is elevated at 33 mg/dL which can indicate impaired function of the kidneys. He has an elevated T3 of 230 ng/dL. He has an elevated T4 of 12.0 ng/dL. 3. You go to assess K.B. What additional data do you need to obtain because he has Graves’ disease? His nutritional status, any nausea or vomiting, any changes in his bowel habits, any bulging of the eyes or vision changes, any changes in his hair/skin/nails, is he having any tremors, does he have shortness of breath, does he have any chest pain, is he sweating more than usual, does he have an increased DTR, does he have a goiter? 4. The physician writes these admission orders. Which will you question, and why? If the patient is dehydrated, why are we giving Lasix. This is a diuretic which can cause further dehydration. His fluids are at a rate of 125/hr. which can be too fast if the patient is having heart failure. Propanolol (betablocker) and Verapamil (CA channel blocker) can also cause progression of heart failure. This study source was downloaded by from CourseH on :13:11 GMT -05:00