M1.4 Discussion Care of Patients with Endocrine Disorders
Group #1:
Compare and contrast the care of clients with acquired hypothyroidism
(Hashimoto’s disease). Gretchen is an 11-year-old who is short in stature
but overweight. Keisha is a 31-year-old woman with a TSH level of 12 who
wishes to become pregnant. Loretta is a 67-year-old woman with long-
standing hypothyroidism. She currently takes levothyroxine once a day.
Please include assessments (including diagnostic testing), care measures
(including medications), and teaching needed for each client.
According to the American Thyroid Foundation, acquired hypothyroidism
(Hashimoto’s disease) is most common in children and adolescents. They
also state that “there is no known reason why people develop Hashimoto’s,
but it tends to run in families.” Patient’s with hypothyroidism will require a
multidisciplinary approach that includes doctors, nurses, endocrinologists,
as well as any other necessary health care members to ensure the patient’s
optimal health goals have been met.
In the case of 11-yr-old Gretchen, due to her being short in stature and
overweight, these are symptoms or signs of growth and developmental
concerns that are associated with hypothyroidism. The nurse should
perform a physical examination, as well as collecting blood tests such as
thyroid antibody testing, TSH and free T4. These will help the nurse to
confirm the child has Hashimoto’s disease. In addition, medication such as
levothyroxine will be provided to the client as the primary treatment.
Appropriate care measures and education would include regular blood
testing to monitor her thyroid’s function, medication adjustments as she
ages, and both the patient and her family should be educated about the
importance of adhering to taking the medication daily.
Next, in the case of Keisha who is a 31-yr-old female with high TSH levels
and desires to become pregnant. When assessing this patient, the nurse
should realize that elevated TSH levels play a role in infertility and
pregnancy outcomes. Here again, the patient will require TSH, free TA,
thyroid antibody testing and a thyroid ultrasound. These also will help to
determine any underlying conditions the patient may have. The choice for
treatment during pregnancy is levothyroxine. Maintaining optimal levels of
TSH during pregnancy will benefit the mother and the fetus. As stated
above, this patient will also require close monitoring of her thyroid levels.
Especially since pregnancy can cause hormonal imbalances. As her
pregnancy progresses the patient’s medication and dosage requirements
will change during her pregnancy. Educate the patient that she will have an
Group #1:
Compare and contrast the care of clients with acquired hypothyroidism
(Hashimoto’s disease). Gretchen is an 11-year-old who is short in stature
but overweight. Keisha is a 31-year-old woman with a TSH level of 12 who
wishes to become pregnant. Loretta is a 67-year-old woman with long-
standing hypothyroidism. She currently takes levothyroxine once a day.
Please include assessments (including diagnostic testing), care measures
(including medications), and teaching needed for each client.
According to the American Thyroid Foundation, acquired hypothyroidism
(Hashimoto’s disease) is most common in children and adolescents. They
also state that “there is no known reason why people develop Hashimoto’s,
but it tends to run in families.” Patient’s with hypothyroidism will require a
multidisciplinary approach that includes doctors, nurses, endocrinologists,
as well as any other necessary health care members to ensure the patient’s
optimal health goals have been met.
In the case of 11-yr-old Gretchen, due to her being short in stature and
overweight, these are symptoms or signs of growth and developmental
concerns that are associated with hypothyroidism. The nurse should
perform a physical examination, as well as collecting blood tests such as
thyroid antibody testing, TSH and free T4. These will help the nurse to
confirm the child has Hashimoto’s disease. In addition, medication such as
levothyroxine will be provided to the client as the primary treatment.
Appropriate care measures and education would include regular blood
testing to monitor her thyroid’s function, medication adjustments as she
ages, and both the patient and her family should be educated about the
importance of adhering to taking the medication daily.
Next, in the case of Keisha who is a 31-yr-old female with high TSH levels
and desires to become pregnant. When assessing this patient, the nurse
should realize that elevated TSH levels play a role in infertility and
pregnancy outcomes. Here again, the patient will require TSH, free TA,
thyroid antibody testing and a thyroid ultrasound. These also will help to
determine any underlying conditions the patient may have. The choice for
treatment during pregnancy is levothyroxine. Maintaining optimal levels of
TSH during pregnancy will benefit the mother and the fetus. As stated
above, this patient will also require close monitoring of her thyroid levels.
Especially since pregnancy can cause hormonal imbalances. As her
pregnancy progresses the patient’s medication and dosage requirements
will change during her pregnancy. Educate the patient that she will have an
