A married couple has come into the clinic for renewal of… A married

A married couple has come into the clinic for renewal of… A married couple has come into the clinic for renewal of prescriptions and annual flu shots. During the encounter, the husband mentions to the nurse that he is concerned about his 69 year old wife. He tells the nurse that she has become very forgetful. She eats very little but has seemed to gain weight. She seems “down” all the time. When ed, the wife states she “just hasn’t been herself”. She admits she doesn’t have much of an appetite. She explains that she has not been active as she used to be and as a result her bowels are not as regular. She thinks those are the reasons she feels “out of sorts”. She chides her husband that his memory “isn’t so hot either.” He insists that she is forgetting simple things while he has always forgotten to write down phone messages and birthdays and such. The nurse is concerned about this patient and carries out a further interview, which reveals the following findings: the patient is generally cold, feels tired all of the time, and really doesn’t have the energy to do much around the house. She finds the thought of going out exhausting. She tells the nurse that her tongue feels thick and she thinks her voice has changed.  The patient agrees to a physical examination. The findings include a weight gain of 10 pounds from her last clinic visit, 6 months ago. Her thyroid is enlarged and palpable. Her skin is dry, she has edema of the lower extremities, and her speech is slow. Her abdomen is distended with bowel sounds in all quadrants.  The nurse recommends that this woman have lab testing for thyroid dysfunction and arranges for consultation with a physician. The nurse schedules a follow-up appointment and makes some recommendations for this patient that includes increasing fluid intake and fiber to improve bowel function. The patient is advised to wear warm clothing and to rest frequently. The nurse explains the functions of the thyroid and that medication can improve all aspects of her current condition when taken regularly.  ·       What may be responsible for the findings about this 69-year-old female?·       What further data should the nurse collect?·       What aspects of physical assessment and what tests are important in arriving at a diagnosis for this         patient?·       How could you determine whether depression was causing the symptoms of “feeling down” and               lack of energy?·       How would you approach the situation if the patient and her husband are Muslim and she is                       required to keep her head covered? Use two scholarly articles to support answers.  Health Science Science Nursing NUR 123 Share EmailCopy link Comments (0)

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