A female client has been on a protein-free diet for 3 months. She comes to the c

Question

A female client has been on a protein-free diet for 3 months. She comes to the clinic with reports of restlessness, heat intolerance, diarrhea, and a significant increase in appetite. (Learning Objectives: 12–14)

What type of endocrine disorder should the nurse suspect and why?

What are other manifestations associated with hyperthyroidism?

Further questioning of the client reveals that she had been diagnosed with hyperthyroidism several years prior, but she had stopped her medication about 6 months ago because she felt so much better.

What is Graves’ disease?

What is a potentially life-threatening complication associated with hyperthyroidism?

What are possible causes for the complication identified in question 4?

Explanation / Answer

Ans 1-) The symptoms of the female client having heat intolerance , increased apetite , restlessness and diarrhea are endocrinal disorders leading to HYPERTHYROIDISM due to excessive activity of hormones T4 and T3 by an overactine Thyroid gland. Excessive amount of thyroid hormones in blood increases body's metabolism resulting into various diseased symptoms leading to ill health.

2-) Other manifestations related to Hyperthyroidism- As hyperthyroidism is common in women so its one symptom also include Decreased menstrual flow and irregular menstrual cycles. Symptoms accompanying the common are heart palpitations, excessive eating without gaining weight, nervousness , shortness of breath, fatigue, anxiety , fine and brittle hairs , difficulty sleeping and sometimes tremors also.

3-) GRAVE'S DISEASE- Exophthalmic goiter or toxic diffuse goiter. It is an autoimmune disease that affects the thyroid and is the most common cause of Hyperthyroidism. In this disease the antibodies produced by immune system stimulates thyroid hormone overproduction. The exact etiology is unknown, however the combination of genetic and environmental factors leads to Grave's disease. Those with family history and having other autoimmune diseases like type1 diabetes , rheumatoid arthritis are more likely to have this disease. There are certain risk factors also associated with its occurence like smoking, inactive lifestyle.

4-) Life threatening comploications of hyperthyroidism- The most life threatening complication if hyperthyroidism is left untreated could lead to problems related to heart. As due to excess thyroid there is heart palpitation and hyperactivity of body due to high metabolism , as a result the body's running on overdrive all the time that affects heart the most. compliocations could result into Arrythmia( abnormal heart beat such asd atrial fibrillation), Cardiac dilation( increased size of heart cavities which thins heart muscles resulting to congestive heart failure), Sudden Cardiac arrest. Hence treating the underlying hyperthyroidism as soon as the symptoms exists could not lead to further complications. Osteoporosis is also a complication of hyperthyroidism.

5-) Causes of complications- Endocrine disorders leads to complications as hormonal disorders are affecting one and the other organs in a sequencial way, because of their functioniong for overall organs of body. Releasing and stimulating of one hormone is affected by others also and so the case with hyperthyroidism . Complications exists due to undertreatment or delayed treatment of the condition. As discussed the body's metabolism is overactive due to overproduction thyroid in the blood stream which further flows to heart leading to its complications which are life threatening.

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