Case 1: A 36-year-old lady named Apple Cider with a past medical history of fibromyalgia presented to her general physician for a regular check-up. The patient reported that her mother was recently diagnosed with hypothyroidism and requested that her scheduled blood work include thyroid function tests. The patient said she has been well; even her symptoms related to fibromyalgia had been under control. Her only complaint was some hair loss, but it had slightly improved since she began using over-the-counter supplements 3 months before her appointment. On physical examination, the patient appeared to be healthy: her vital signs were normal, there was no evidence of thyroid eye disease, tremor, or tachycardia; and her thyroid gland was not enlarged. Blood work completed the same day revealed normal complete blood count and liver and kidney function tests, but thyroid-stimulating hormone (TSH) was low, measuring 0.02 µIU/mL (reference range, 0.4-4.6 mIU/L). Free thyroxine (T4) was measured at 24 pmol/L (reference range, 10-19 pmol/L), and free triiodothyronine was measured at 7.1 pmol/L (reference range, 3.5-6.5 pmol/L). After review of her previous laboratory tests, it was found that her thyroid function tests, including TSH and free T4 levels, were previously normal on several occasions. In a follow-up visit, the patient denied recent pregnancy, iodine exposure, neck pain or fever, recent acute illness, and symptoms of thyrotoxicosis. In addition, she denied receiving any new medication, specifically amiodarone or lithium. Create a Nursing Care Plan focusing on the possible adverse effect of administering specific medication based on the case of the patient. You have review and read first the medication intended for this patient before you can proceed to the Nursing Care Plan.

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Case 1: A 36-year-old lady named Apple Cider with a past medical history of fibromyalgia presented to her general physician for a regular check-up. The patient reported that her mother was recently diagnosed with hypothyroidism and requested that her scheduled blood work include thyroid function tests. The patient said she has been well; even her symptoms related to fibromyalgia had been under control. Her only complaint was some hair loss, but it had slightly improved since she began using over-the-counter supplements 3 months before her appointment. On physical examination, the patient appeared to be healthy: her vital signs were normal, there was no evidence of thyroid eye disease, tremor, or tachycardia; and her thyroid gland was not enlarged. Blood work completed the same day revealed normal complete blood count and liver and kidney function tests, but thyroid-stimulating hormone (TSH) was low, measuring 0.02 µIU/mL (reference range, 0.4-4.6 mIU/L). Free thyroxine (T4) was measured at 24 pmol/L (reference range, 10-19 pmol/L), and free triiodothyronine was measured at 7.1 pmol/L (reference range, 3.5-6.5 pmol/L). After review of her previous laboratory tests, it was found that her thyroid function tests, including TSH and free T4 levels, were previously normal on several occasions. In a follow-up visit, the patient denied recent pregnancy, iodine exposure, neck pain or fever, recent acute illness, and symptoms of thyrotoxicosis. In addition, she denied receiving any new medication, specifically amiodarone or lithium. Create a Nursing Care Plan focusing on the possible adverse effect of administering specific medication based on the case of the patient. You have review and read first the medication intended for this patient before you can proceed to the Nursing Care Plan.

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