NU636 Unit 4: Discussion 2 Treatment of Hypothyroidism

Initial Response

Scenario

You are evaluating a 53-year-old white female who wants to talk to you about lab work that she had done recently at “Any Lab Test Now”.

She wanted to have lab work done because she was feeling tired and unmotivated. Additionally, she had put on about 15 pounds even though she has been teaching yoga 2-3 times a week for the last few years.
The lab results reveal a TSH of 93.
She reports her last menstrual period was about 3 years ago. She experienced some menopausal symptoms of hot flashes and night sweats. However, she states they weren’t too much of a problem and those resolved a couple years ago.
She denies any difficulty swallowing or neck pain/tenderness.
Constitutional exam: 5’5” tall, 154 pounds, BP 145/88, P 60, R 16, Temp 97.2
Neck – nontender, mild goiter with right side of thyroid larger than the left side
Heart – regular rhythm without murmur or gallop
Lungs – clear
Skin – dry on extremities with some flaking noted
A slowness of the relaxation phase of the Achilles tendon reflex is noted

Please develop a discussion that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.

Initial Post

Utilize the information provided in the scenario to create your discussion post.

Construct your response as an abbreviated SOAP note (Subjective Objective Assessment Plan).

Structure your ‘P’ in the following format: [NOTE: if any of the 3 categories is not applicable to your plan please use the ‘heading’ and after the ‘:’ input N/A]

Therapeutics: pharmacologic interventions, if any – new or revisions to existing; include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention]

Educational: health information clients need in order to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit

Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making

Support the interventions outlined in your ‘P’ with scholarly resources.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Solution: NU636 Unit 4: Discussion 2 Treatment of Hypothyroidism

A 53-year-old white female presents with concerns regarding recent lab work. She has been feeling tired and unmotivated and gained 15 lbs despite yoga 2-3x/week. Labs reveal highly elevated TSH of 93. She is post-menopausal for 3 years with resolved hot flashes/night sweats. No difficulty swallowing or neck pain.

Vitals: BP 145/88, P 60, R 16, Temp 97.2. Neck exam reveals mild goiter with right lobe larger than left, nontender. Dry skin on extremities with flaking. Slow Achilles reflex noted. Heart and lungs normal.

Based on the patient’s constellation of symptoms including fatigue, weight gain, dry skin and slow reflexes in the setting of highly elevated TSH of 93 and physical exam findings of mild goiter, the diagnosis includes primary hypothyroidism due to Hashimoto’s thyroiditis (Wilson et al., 2021). Hypothyroidism is most often caused by autoimmune thyroid disease, also known as Hashimoto’s disease (Wilson et al., 2021). It is the result of white blood cells penetrating the thyroid, which causes the gland to fibrose more and lessen its ability to function (Wilson et al., 2021). The patient’s thyroid may be enlarged, but otherwise functioning normally; yet, there may be an overactive antibody component.

Therapeutics:

Initiate Levothyroxine at a low starting dose of 25 mcg orally once daily to begin treatment for…Please click purchase button below to get full answer for $5

(Solution) NU636 Unit 4: Discussion 2 Treatment of Hypothyroidism