Question

Active Learning Template: System Disorder

1) Hyperthyroidism: Teaching About the Manifestations of Thyroid Storm (Ch. 78 - ATI med surg)

2) Pituitary Disorders: Medications to Treat Diabetes Insipidus (Ch. 77 - ATI med surg)

NT System Disorder

Alterations in Health (Diagnosis)

Patho related to problem

health promotion & disease prevention

risk factors

expected findings

safety considerations

laboratory test

diagnostic procedure

nursing care

therapeutic procedures

medications

client education

interprofessional care

complications

Answer 1

ACTIVE LEARNING TEMPLATE:

THYROID STORM:

Alterations in Health (Diagnosis):

• Examination of thyroid signs and symptoms
• Evaluation of T3 and T4 levels.
• Low TSH level.

Patho related to the problem:

Untreated hyperthyroidism leads to overproduction of hormones T3 and T4 level. A large amount of thyroid hormone results in thyroid storm.

Health promotion and disease prevention:

• Maintain thyroid level by following the therapy.
• Treatment of underlying cause.
• Exercise
• Reduction of stress.
• Adequate diet intake.

Risk factors:

• Autoimmune diseases
• Thyroid Nodules
• Consuming too much iodine.
• Patient with untreated hyperthyroidism.

Expected findings:

• Lag of eye movement
• thinning of hair
• goiter
• bruit
• dyspnea
• tachycardia

Safety:

• Caution should be taken in treating pregnant women.
• The older adult can develop atrial fibrillation so precautions should be followed.

Laboratory test:

• T3
• T4
• TSH Level
• Thyroid stimulating immunoglobulins
• Antibodies of the thyrotropin receptor

Diagnostic procedure:

• ECG
• USG
• Radioactive iodine uptake.

Nursing care:

• Assist in daily activities and minimizes energy expenditure.
• Monitor nutritional status.
• Monitor daily weight.
• Provide comfort environment.
• Administer medications regularly.

Therapeutic procedures:

Radioiodine uptake test or surgical removal of the thyroid gland is the therapeutic procedure to treat the thyroid storm.

Medications:

• Beta-blocker
• Potassium iodide
• Glucocorticoid
• Propylthiouracil

Client Education:

• Assess for the iodine allergy.
• Radioactive iodine should be taken prior to 24hrs.
• Educate about protein-rich diet.

Interprofessional care:

• Radiotherapist should instruct the patient before and after the procedure.
• The physician should examine the patient before the surgery.
• The nurse should monitor the client before and after the procedure.

Complication:

• Atrial fibrillation
• Osteoporosis
• Heart failure