Exemplar 4: NR508 Hypothyroidism vs.
Hyperthyroidism Treatment Goals for Maria
The main objective for Maria, a 46-year old woman who presents for her yearly physical,
will be addressing her increased thyroid-stimulating hormone (TSH) levels, her new diagnosis of
diabetes, and her obesity status. Several tests are done to diagnose diabetes. Diagnosis of
diabetes includes random blood sugar levels above 200 mg/dL, HbA1C level above 6.5%, fasting
glucose greater than 126 mg/dL, or a 2-hour plasma glucose level above 200 mg/dL during an
oral glucose tolerance test (Reece et al., 2018). The anomalous functioning of her thyroid affects
diabetes control because the thyroid is vital in metabolism regulation (Shabnam et al., 2015).
Therefore, untreated thyroid disorder may worsen the symptoms of diabetes (Shabnam et al.,
2015). The normal range of TSH is 0.34–4.25 IU/mL (Peterson et al., 2016). The patient’s
TSH laboratory test and symptoms confirm the diagnoses of hypothyroidism. Levothyroxine will
lower the patient’s TSH level. Maria’s TSH would, therefore, need to be checked after 6–8
weeks of its administration.
Drug Therapy
According to ADA (2018), metformin is the first line of treatment for diabetes mellitus.
Metformin is also noted for its positive results on weight loss and cardiovascular progression
(Reece et al., 2018). Maria’s glomerular filtration rate (GFR) level must be considered, however,
because the drug metformin is not recommended for people with a GFR below 30ml/minute.
According to Epocrates (2018), this drug reduces the production of glucose and raises peripheral
glucose uptake to boost insulin sensitivity. To ensure that Maria tolerates the medication, the
lowest dose would be recommended initially, which is 500 mg/day (Reece et al., 2018). The
nurse practitioner will advise the patient on the time needed to produce therapeutic results, which
This study source was downloaded by 100000856941565 from CourseHero.com on 12-01-2022 03:24:06 GMT -06:00
https://www.coursehero.com/file/118345149/malaria-treatment-and-therapydocx/
Hyperthyroidism Treatment Goals for Maria
The main objective for Maria, a 46-year old woman who presents for her yearly physical,
will be addressing her increased thyroid-stimulating hormone (TSH) levels, her new diagnosis of
diabetes, and her obesity status. Several tests are done to diagnose diabetes. Diagnosis of
diabetes includes random blood sugar levels above 200 mg/dL, HbA1C level above 6.5%, fasting
glucose greater than 126 mg/dL, or a 2-hour plasma glucose level above 200 mg/dL during an
oral glucose tolerance test (Reece et al., 2018). The anomalous functioning of her thyroid affects
diabetes control because the thyroid is vital in metabolism regulation (Shabnam et al., 2015).
Therefore, untreated thyroid disorder may worsen the symptoms of diabetes (Shabnam et al.,
2015). The normal range of TSH is 0.34–4.25 IU/mL (Peterson et al., 2016). The patient’s
TSH laboratory test and symptoms confirm the diagnoses of hypothyroidism. Levothyroxine will
lower the patient’s TSH level. Maria’s TSH would, therefore, need to be checked after 6–8
weeks of its administration.
Drug Therapy
According to ADA (2018), metformin is the first line of treatment for diabetes mellitus.
Metformin is also noted for its positive results on weight loss and cardiovascular progression
(Reece et al., 2018). Maria’s glomerular filtration rate (GFR) level must be considered, however,
because the drug metformin is not recommended for people with a GFR below 30ml/minute.
According to Epocrates (2018), this drug reduces the production of glucose and raises peripheral
glucose uptake to boost insulin sensitivity. To ensure that Maria tolerates the medication, the
lowest dose would be recommended initially, which is 500 mg/day (Reece et al., 2018). The
nurse practitioner will advise the patient on the time needed to produce therapeutic results, which
This study source was downloaded by 100000856941565 from CourseHero.com on 12-01-2022 03:24:06 GMT -06:00
https://www.coursehero.com/file/118345149/malaria-treatment-and-therapydocx/
