The client reports significant fatigue that has worsened over the past eight weeks. Additionally, the client reports constipation, hair loss, and a 3-kilogram (6.6 pounds) weight gain. She reports missing work because of difficulty concentrating and persistent fatigue.
The client is alert and fully oriented. She appears fatigued and reports dizziness when she moves quickly. Periorbital edema, various bruises, and facial swelling were noted on assessment. Peripheral pulses were intact and weak. The client denies any pain.
Oral temperature 97 F (36.1o C); Pulse 51/minute; Respirations 15/minute.
BP 93/61 mm Hg; Oxygen saturation 95% on room air.
➢ Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
Action to Take: Obtain a prescription for levothyroxine | Obtain a prescription for methimazole | Have the client complete a blood transfusion consent | Obtain an order for a urine cortisol level | Initiate fall precautions
Potential Conditions: Graves’ disease | Cushing’s syndrome | Hypothyroidism | Systemic Lupus Erythematosus | Adrenal Insufficiency
Parameters to Monitor: Vital Signs | Serum TSH/T3/T4 levels | Intake and Output | Cortisol Level | BUN and Creatinine
Action to Take: Obtain a prescription for levothyroxine | Obtain a prescription for methimazole | Have the client complete a blood transfusion consent | Obtain an order for a urine cortisol level | Initiate fall precautions
Parameters to Monitor: Vital Signs | Serum TSH/T3/T4 levels | Intake and Output | Cortisol Level | BUN and Creatinine
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