Patho 6

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Nursing

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Nov 24, 2024

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1 Advanced Pathophysiology Student’s Name University Affiliation Course Professor’s Name

2 Case 1 The Kind of Thyroid Condition That Ms. Jefferson May Have The patient most likely has a thyroid condition called hypothyroidism, which is the primary illness. This condition occurs when the thyroid gland is unable to produce and release an adequate amount of thyroid hormone into the bloodstream, which in turn slows down the rate at which the body burns calories. In this particular instance, the disease has been pointed up by a high level of TSH, which indicates the presence of the hypothyroidism ailment. Those who have a thyroid gland that functions regularly are regarded to have a TSH level that falls within the reference range, which is defined as 0.4 mu/l for the hormone known as thyroid-stimulating hormone (TSH). Hypothyroidism is diagnosed when a patient's TSH level is greater than 4.0 m/U/L and their T4 levels are low (Fang et al., 2022). The patient's laboratory exam revealed a T4 level of 3.0 mcg/dL, which is a clear sign of hypothyroidism. The normal range for T4 must lie between 4.5 and 11.2 mcg/dL. The Patient's Thyroid Disorder Doesn't Have Any Symptoms. It is untrue to assume that Ms. Jefferson's thyroid ailment is rare in that it has no symptoms. As hypothyroidism develops gradually, it could take months or even years before the condition's symptoms are properly diagnosed (Martos-Moreno et al., 2019). Many symptoms, including fatigue and weight gain, are typical and may not always indicate that a patient has a thyroid disorder. In this instance, the patient failed to inform the healthcare professional of any symptoms. As a result, the lack of symptoms may be a common sign of the particular thyroid problem. Possible Cause of The Patient's Thyroid Disorder

3 Since the patient has not reported any symptoms of the illness, it is important to depend on the findings of the laboratory tests to identify the disease that is thought to be causing the thyroid issue before developing a treatment strategy. According to the findings of the laboratory tests, persistent autoimmune thyroiditis linked to Hashimoto thyroiditis may be the most likely cause of the hypothyroidism seen with low T4 levels and increased TSH (Ibrahim et al., 2021). Due to the thyroid being attacked and destroyed by the body's immune system, Hashimoto's disease prevents the thyroid from producing and releasing enough thyroid hormone, which results in hypothyroidism. Reaction To The Patient's Updated Assessment of Their Condition A yearly assessment of the patient's thyroid health is required; this is sometimes referred to as an annual physical. The yearly examination will be done in light of the patient's medical history and a careful evaluation of any previously identified illnesses. The patient's test results revealed a thyroid problem, and her next checkup will be needed to assess her health. The recommended course of action is to schedule a follow-up appointment for a TSH level check six weeks after starting therapy, which is the typical assessment period for thyroid levels (De Mello et al., 2022). If the thyroid levels remain steady, a yearly evaluation will be performed. Symptoms Of the Thyroid Condition Depending on how severe the hormone shortage has developed, the symptoms of hypothyroidism disease often change over time. The onset of symptoms is typically slow, taking years or even decades. Symptoms are not being reported by the patient, although they might develop over time. Symptoms including weight gain, exhaustion, aversion to the cold, stress, pulse, and diarrhea may be brought on by low T4 levels and excessive TSH levels in the blood (Shames & Wenzel, 2022). To provide the patient with proper care management both during and

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4 after treatment, the patient must closely monitor any symptom occurrence and communicate it to the medical practitioner. Case 2 Cause Of the Patient's Loss of Glucose Reduced glucose levels are an issue for the majority of diabetes people. The usage of an increased prednisone dosage is the most likely factor contributing to the patient's loss of glycemic control. Prednisone medication for asthma can raise blood sugar levels by rendering the liver less responsive to insulin (Zaman, 2020). Diabetes may result from a problem with how the body uses insulin or a problem with how the pancreas produces insulin. When blood sugar levels rise, the pancreas releases insulin, which travels to the liver and causes a drop in sugar levels. Important Action to Be Taken by The Patient The incorporation of glucocorticoids in a treatment plan must be closely monitored by a medical professional to provide the patient with the right instructions on how to take the medication and deal with any potential adverse effects (Gregson et al., 2022). When there are signs of infection, the most crucial thing to do is to call a healthcare professional. Glucocorticoid treatment comes with several hazards, and if the prescription is taken for a longer amount of time, the side effects may be severe. As a result, it's important to let the patient know so they can help you monitor the progression of any symptoms, such as the flu, or any other red flags that would necessitate a doctor's involvement to keep the patient from suffering serious consequences. The Patient Is Likely to Be Affected by Endocrine Conditions.

5 The patient's lifestyle and the case study's medical history will be used to determine which endocrine ailment is most likely to harm the patient. Prednisone and other oral corticosteroids should be taken in greater amounts for a longer period if the patient is to develop Cushing syndrome (Savas et al., 2022). The 50-year-old lady has a history of asthma, and she has been taking large dosages of prednisone for the last three weeks to lessen the severity of her problem. Prednisone has made it easier for the patient to breathe, but she has gained weight and is increasingly exhausted. These symptoms are a blatant sign that the patient is at high risk of developing Cushing syndrome due to excessive prednisone dose. Appropriate Intervention for Glucose Control Using the right intervention strategies to help with glucose management, the healthcare professional must make sure the patient feels better. Insulin administration as needed using a standard sliding scale is the optimal strategy for the patient's glucose management (Polavarapu et al., 2022). A key factor in keeping the body's blood glucose levels within the desired range is the utilization of insulin. By taking glucose out of circulation and putting it into every cell in the body, it does this. As I turn, the cells store any surplus glucose in the liver, muscles, and tissue for use as energy when needed. As metformin alone cannot be relied upon to manage type 2 diabetes condition, the Patient will need insulin treatment on a sliding scale as needed, as advised by the doctor. In addition, the patient should be encouraged to exercise more because doing so may help drop blood sugar levels for several hours while you sleep. When the patient's blood is utilized for energy during exercise, this effect may be more pronounced. Frequent exercise increases the sensitivity of the body's cells to the effects of insulin, assisting in the maintenance of normal blood sugar levels.

6 References de Mello, R. B., Giassi, K., Stahl, G., Assis, M. L. M., Flores, M. S., de Lima, B. C., ... & da Costa Rodrigues, T. (2022). Evaluation of Bedtime vs. Morning Levothyroxine Intake to Control Hypothyroidism in Older Patients: A Pragmatic Crossover Randomized Clinical Trial. Frontiers in Medicine , 9 . https://doi.org/10.3389%2Ffmed.2022.828762 Fang, T., Lin, L., Ou, Q., Lin, L., Zhang, H., Chen, K., ... & He, Y. (2022). An Investigation on the Risk Factors of Thyroid Diseases in Community Population in Hainan. International Journal of Endocrinology , 2022 . https://doi.org/10.1155/2022/4514538 Gregson, C. L., Armstrong, D. J., Bowden, J., Cooper, C., Edwards, J., Gittoes, N. J., ... & Compston, J. (2022). UK clinical guideline for the prevention and treatment of osteoporosis. Archives of osteoporosis , 17 (1), 58. https://doi.org/10.1007/s11657-022- 01115-8 Ibrahim, S. I., Khalafalla, A. M., Safan, A. S., Alsaud, A. E., Batia, T. B., & Yassin, M. A. (2021). Acute psychosis secondary to steroid-responsive encephalopathy associated with autoimmune Hashimoto's thyroiditis. Clinical Case Reports , 9 (9). https://doi.org/10.1002%2Fccr3.4644 Martos-Moreno, G. Á., Lecumberri, B., & de Nanclares, G. P. (2019). Implication in Paediatrics of the First International Consensus Statement for the Diagnosis and management of pseudohypoparathyroidism and related disorders. Anales de Pediatría (English Edition) , 90 (2), 125-e1. https://doi.org/10.1016/j.anpede.2019.01.001 Polavarapu, P., Pachigolla, S., & Drincic, A. (2022). Glycemic Management of Hospitalized Patients Receiving Nutrition Support. Diabetes Spectrum , 35 (4), 427-439. https://doi.org/10.2337/dsi22-0010

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7 Savas, M., Mehta, S., Agrawal, N., van Rossum, E. F., & Feelders, R. A. (2022). Approach to the patient: diagnosis of Cushing syndrome. The Journal of Clinical Endocrinology & Metabolism , 107 (11), 3162-3174. https://doi.org/10.1210/clinem/dgac492 Shames, R., & Wenzel, S. (2022). On the Fundamental Efficacy of Thyroid Hormone Therapy in Eating Disorders: Review of Mechanisms and Case Study. Journal of Restorative Medicine , 12 (1). doi:10.3389/fendo.2019.00350. Zaman, G. S. (2020). Pathogenesis of insulin resistance. In Cellular metabolism and related disorders . London, UK: IntechOpen. DOI: 10.5772/intechopen.92864

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