Case Study 79 Hyperthyroidism and Graves Disease.
Scenario
K.B. is a 65-year-old man admitted to the hospital after a 5-day episode of “the flu” with
complaints of dyspnea on exertion, palpitations, chest pain, insomnia, and fatigue. K.B. was
diagnosed with Graves’ disease 6 months ago and placed on methimazole (Tapazole)
15mg/day. His other past medical history includes heart failure and hypertension requiring
antihypertensive medications; however, he states that he has not been taking these
medications on a regular basis. Vital signs (VS) are: 150/90, 124 irregular, 20, 100.2 °F (37.9° C).
Admission assessment findings are: height 5ft, 8 in; weight 132lb; appears anxious and restless;
loud heart sounds; 1+ pitting edema noted in bilateral lower extremities; diminished breath
sounds with fine crackles in the posterior bases. K.B. begins to cry when he tells you he recently
lost his wife; you notice someone has punched several more holes in his belt so he could
tighten it.
1. Which of K.B.'s assessment findings represent manifestations of
hypermetabolism? Bp pulse, high temp, tachypnea, anxiety, insomnia restlessness,
2. Interpret K.B.'s laboratory
results. T3 and T4 are elevated
BUN- elevated, impaired kidney function from dehydration from increased metabolic
state ESR- elevated from inflammation for infection or tissue necrosis
HGB, HCT low caused by hypermetabolic state
This study source was downloaded by 100000810282105 from CourseHero.com on 10-17-2022 10:11:54 GMT -05:00
https://www.coursehero.com/file/60223214/Case-Study-79-Hyperthyroidism-and-Graves-Diseasedocx/
, Case Study 79 Hyperthyroidism and Graves Disease.
3. You go to assess K.B. What additional data do you need to obtain because he has
Graves’ disease?
Goiter
N/V- nutritional status
Ask about chest pain or feeling palpitations
SOB?
Changes in bowel habits?
Increased DTR
Tremors
Bulging eyes, blurred
vision Diaphoresis
Changes in hair skin and nails
This study source was downloaded by 100000810282105 from CourseHero.com on 10-17-2022 10:11:54 GMT -05:00
https://www.coursehero.com/file/60223214/Case-Study-79-Hyperthyroidism-and-Graves-Diseasedocx/
Scenario
K.B. is a 65-year-old man admitted to the hospital after a 5-day episode of “the flu” with
complaints of dyspnea on exertion, palpitations, chest pain, insomnia, and fatigue. K.B. was
diagnosed with Graves’ disease 6 months ago and placed on methimazole (Tapazole)
15mg/day. His other past medical history includes heart failure and hypertension requiring
antihypertensive medications; however, he states that he has not been taking these
medications on a regular basis. Vital signs (VS) are: 150/90, 124 irregular, 20, 100.2 °F (37.9° C).
Admission assessment findings are: height 5ft, 8 in; weight 132lb; appears anxious and restless;
loud heart sounds; 1+ pitting edema noted in bilateral lower extremities; diminished breath
sounds with fine crackles in the posterior bases. K.B. begins to cry when he tells you he recently
lost his wife; you notice someone has punched several more holes in his belt so he could
tighten it.
1. Which of K.B.'s assessment findings represent manifestations of
hypermetabolism? Bp pulse, high temp, tachypnea, anxiety, insomnia restlessness,
2. Interpret K.B.'s laboratory
results. T3 and T4 are elevated
BUN- elevated, impaired kidney function from dehydration from increased metabolic
state ESR- elevated from inflammation for infection or tissue necrosis
HGB, HCT low caused by hypermetabolic state
This study source was downloaded by 100000810282105 from CourseHero.com on 10-17-2022 10:11:54 GMT -05:00
https://www.coursehero.com/file/60223214/Case-Study-79-Hyperthyroidism-and-Graves-Diseasedocx/
, Case Study 79 Hyperthyroidism and Graves Disease.
3. You go to assess K.B. What additional data do you need to obtain because he has
Graves’ disease?
Goiter
N/V- nutritional status
Ask about chest pain or feeling palpitations
SOB?
Changes in bowel habits?
Increased DTR
Tremors
Bulging eyes, blurred
vision Diaphoresis
Changes in hair skin and nails
This study source was downloaded by 100000810282105 from CourseHero.com on 10-17-2022 10:11:54 GMT -05:00
https://www.coursehero.com/file/60223214/Case-Study-79-Hyperthyroidism-and-Graves-Diseasedocx/
