Case Study Thyroid

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CASE STUDY Assignment: Thyroid Drugs Ms. Kissinger, 43-yr-old Caucasian female, comes to the urgent care clinic, complaining of weakness, insomnia, awakening during the night with “a rapid heart beat,” and “feeling anxious.” Ms. Kissinger denies chest pain or shortness of breath associated with her rapid heartbeat. She also complains of muscle tremors when doing small motor activities and “can’t wait for the summer to end” because she cannot tolerate the heat. Past medical history includes hypertension diagnosed 8 years ago. Family history includes one sister with “thyroid problems.” Social history includes a twenty-five pack-year history of cigarette smoking, although she quit 5 years ago. She also consumes one to two drinks of brandy per week. She has owned a gas station for the past 12 years. She is single and not sexually active. Data Obtained From Nursing Assessment System review reveals a thin woman with complaints of increasing fatigue and weakness for the past 3 to 4 months, increased frequency of bowel movements—now “watery”—hyperactive bowel sounds, 9-pound weight loss over the past six weeks with a noticeable increase in appetite—“I’ve lost weight without even trying”—and slight hand tremor. Ms. Kissinger complains “my eyes look like they are bulging.” . She is diaphoretic. . VS: temperature, 99.4F; blood pressure, 134/86; pulse, 124 and regular; respirations, 18 . Neck is supple with a nontender, palpable enlarged thyroid. . Following a series of laboratory analyses, a diagnosis of hyperthyroidism, specifically Graves’ disease, has been made. Lab Data . CBC, Chem 7: WNL . Free T3: 2.3 ng/dL . Free T4: 5.3 ng/dL . TSH: 0.08 mIU/L Current Drug Therapy . HCTZ, 25 mg PO qd . Tylenol, prn for shoulder pain . Methimazole, 10 mg PO tid Approximately 2 months later,

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