Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient. Three (3) resources after 2008 are required along with APA format.
Endocrine Case Study
You meet a 35-year-old woman who is thin, anxious, who cannot seem to sit still. She is sweating although the room temperature is 68 degrees Fahrenheit. She has bulging eyes and a staring appearance. Her skin is smooth and moist, and her hair is fine. She states that she is always and and that she does not button the top buttons on her blouses anymore, because her collars are too tight. Lab results show that she has Grave’s disease.
1. Given her diagnosis, what should she expect regarding her weight and appetite?
2. Why is she always warm?
3. What is the basic pathophysiology of Grave’s disease?
4. What would you expect to see when you evaluate her vital signs and why do these findings occur?
5. What is the term used to describe her protruding eyes and why are they protruding?
6. Why are her collars too tight?
7. What medications would you expect to see ordered for this patient?
8. What complication(s) would you want to discuss with this patient to seek further medical attention?
Endocrine Case Study
Patient Presentation
A 35-year-old woman presents with a constellation of symptoms suggestive of hyperthyroidism, including:
Laboratory Findings
Laboratory findings confirm the diagnosis of Graves’ disease, an autoimmune disorder characterized by excessive thyroid hormone production. Elevated levels of triiodothyronine (T3) and thyroxine (T4) are typically seen, along with suppressed thyroid-stimulating hormone (TSH) levels.
Cellular Level Pathophysiology
The underlying pathophysiology of Graves’ disease involves the production of autoantibodies, known as thyroid-stimulating antibodies (TSIs), which mimic the action of TSH and stimulate the thyroid gland to produce excessive thyroid hormones. This excessive thyroid hormone production leads to a cascade of effects at the cellular level, including:
Expected Findings on Vital Signs Evaluation
Upon evaluating the patient’s vital signs, we would expect to see the following:
Exophthalmos (Protruding Eyes)
Exophthalmos, also known as Graves’ ophthalmopathy, is a common manifestation of Graves’ disease. It is caused by the accumulation of retrobulbar connective tissue and infiltration of inflammatory cells in the orbital region. This leads to an increase in orbital pressure, pushing the eyeballs forward and giving the appearance of protruding eyes.
Skin Changes
The patient’s smooth, moist skin is a manifestation of hyperthyroidism. Thyroid hormones increase the production of sebum, leading to oily skin. They also increase blood flow to the skin, contributing to the warm and flushed appearance.
Fine Hair
Fine hair is another manifestation of hyperthyroidism. Thyroid hormones increase the turnover rate of hair follicles, leading to a shorter hair growth cycle and finer hair strands.
Difficulty Tolerating Constrictive Clothing
The patient’s difficulty tolerating constricting clothing, particularly around the neck, is due to the enlargement of the thyroid gland, known as a goiter. The enlarged thyroid gland can compress surrounding structures, including the trachea and esophagus, leading to symptoms of dysphagia (difficulty swallowing) and dyspnea (difficulty breathing).
Medications
Medications commonly prescribed for Graves’ disease include:
Potential Complications
Complications associated with Graves’ disease include:
Patient Education
It is crucial to educate the patient about Graves’ disease, its management, and potential complications. This includes: