Acute Nursing Management Nursing Care Plan 2014.
Overview of the pathophysiology of hyperthyroidism.
Summary of care plan and discharge plan. (250 words)
References
Assessment Item – Case study
Length: 2000 words
Learning outcomes assessed 1,2,
Past History
Two Months ago Susan Jones, a 43-year-old woman was admitted to hospital with a high fever of unknown origin. The results of her physical examination and blood tests are below.
Physical examination results:
• Temperature 400 C
• BP 150/78
• Pulse 118 beats per minute
• RR 24 breaths per minute
• Skin is moist and hot
• Fine hand tremors
• 4+ deep tendon reflexes and muscle strength of 1-2
• She has a protrusion of the eyes with lid retraction
• She also states that she has lost a significant amount of weight loss recently and is increasingly finding herself to be anxious and irritable.
• She says that she has also noticed that she does not tolerate heat very well and is sweating a lot.
Blood test results
Blood component Result Normal values
Haemoglobin 12.0g/dL 11.5-16.0g/dL
White cell count 10.4 x 109/L 4.0 – 11.0 x 109/L
Platelets 250 x 109/L 150 – 400 x 109/L
Sodium 137mmol/L 135 – 145 mmol/L
Potassium 3.7mmol/L 3.5 -5.0 mmol/L
Urea 5 mmol/L 2.5 – 6.7 mmol/L
Creatinine 79 µmol/L 44 – 80 µmol/L
Thyroid stimulating hormone (TSH) 0.01 mu/L 0.5 – 5.7 mu/L
Tri-iodothyronine (T3) 17pmol/L 2.5 – 5.3 pmol/L
Thyroxine (T4) 42pmol/L 9 – 22pmol/L
Following diagnostic investigation’s she was diagnosed as having Graves’ disease.
Collaborative Plan
Susan has been taking antithyroid medications since she was diagnosed to produce a euthyroid state.
They are:
Propylthiouracil (PTU) oral 100mg TDS
Propanolol oral 160mg/daily
Now that Susan’s blood results have indicated that she has a euthyroid state, subsequently surgery has been scheduled for a subtotal thyroidectomy.
Background information.
Susan has 2 children Sam who is 10 years old and Morgan who is 13 years old. Susan has divulged that she is very nervous about the surgery. This is because she has not been away from her children. This she says is because her partner Geoff is a fly in fly out worker and Sam has a learning difficulty, which restricts his activities and ability to socialise with other children. Susan has been able to persuade her Mother-in-law, Roseleen, to come and care for the children whilst she is undergoing treatment. However, Roseleen is disapproving of Susan’s management of Sam and believes there is nothing wrong other than a lack of discipline. Roseleen has also commented in the past that Geoff should be at home every night, to provide ‘a firm hand’, and that his work situation is not acceptable.
Your Task
You are to provide a comprehensive nursing care plan for Susan that demonstrates the critical reasoning cycle. Your plan must be focused on the holistic nursing management of Susan and include the pre-operative care and education, as well as the post-operative management.
Your paper must include:
• An overview of the pathophysiology of Susan’s condition.
• Prioritise the nursing interventions in the nursing care plan for Susan.
• A rationale for each of your suggested nursing diagnoses and interventions based upon evidence and best practice principles.
• Demonstrate the ability to reflect by the delivery of a holistic approach to the patient in the case study.
• A summary of your findings with some discharge planning for Susan.
PLACE THIS ORDER OR A SIMILAR ORDER WITH NURSING TERM PAPERS TODAY AND GET AN AMAZING DISCOUNT
