Case Study Assignment: Head neck with vision
Case Study Assignment: Head neck with vision
Head and Neck Vision Case Study
What risks involving the head and neck are addressed by assessment documentation?
The assessment documentation addresses neck and thyroid disorders. The enlargement of the thyroid gland demonstrates increased secretion of thyroid-stimulating hormone by the pituitary gland or lymphocyte production of immunoglobulin that is similar to thyroid-stimulating hormone. The documentation also demonstrates the possibility of inflammatory, neoplastic, and infiltrative diseases that cause goiter. Progressive thyroid gland enlargement results in it becoming multinodular and asymmetrical. Over time, the goiter becomes vascular leading to symptoms such as thrills and bruits. The documentation might also mean that the patient has autoimmune thyroid disease (Lee & Pearce, 2022). Some of the expected findings include cobblestone texture in the thyroid gland. Hard and enlarged submandibular lymph nodes could be attributed to acute bacterial infections.
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What diagnostics would the nurse midwife expect from her assessment discoveries?
Appropriate diagnostic and laboratory investigations should be performed to rule out the above conditions. They include thyroid gland ultrasonography, tissue biopsy for microscopic examination, and thyroid function tests. A complete blood count might also be needed to rule out infections (Lee & Pearce, 2021). A thyroid antibody test might also be required to rule out thyroid autoimmune disease.
How would the nurse midwife proceed in light of her assessment data?
The nurse will educate the patient about the assessment data. This includes educating her about the required laboratory and diagnostic investigations and their implication for her pregnancy. The nurse should also collaborate with a physician, an endocrinologist, and an obstetrician to determine the most appropriate treatment for the patient. The treatment will entail weighing the benefits and risks of the recommended anti-thyroid treatments for hyperthyroidism, goiter, or Graves disease. Pregnant clients with hyperthyroidism have an increased risk of preeclampsia, miscarriage, heart failure, and preterm births (Anandappa et al., 2020; Lee & Pearce, 2022). Consequently, proper case management is crucial to ensure positive outcomes for the mother and the unborn baby.
References
Anandappa, S., Joshi, M., Polanski, L., & Carroll, P. V. (2020). Thyroid disorders in subfertility and early pregnancy. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820945855. https://doi.org/10.1177/2042018820945855
Lee, S. Y., & Pearce, E. N. (2021). Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy. The Journal of Clinical Endocrinology & Metabolism, 106(3), 883–892. https://doi.org/10.1210/clinem/dgaa945
Lee, S. Y., & Pearce, E. N. (2022). Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nature Reviews Endocrinology, 18(3), 158–171. https://doi.org/10.1038/s41574-021-00604-z
Crystal Acton, a 27-year-old married woman, pregnant with her first child, presents at the ob/gyn clinic for her first prenatal visit. The nurse midwife begins her assessment of this patient by documenting a medical and family history.
Mrs. Acton states that the only medication she is taking is a multivitamin with folic acid daily. She has no family history of breast, ovarian, or vaginal cancer.
While performing the physical assessment, the nurse midwife notes a thrill over the thyroid gland, which feels markedly enlarged. Auscultation confirms a bruit in the thyroid area.
Documentation includes the following: Head WNL; submental and submandibular lymph nodes hard and enlarged; thyroid gland markedly enlarged, thrill palpated, bruit auscultated.
The nurse prepares a teaching plan for this patient.
What risks involving the head and neck are addressed by assessment documentation?
What diagnostics would the nurse midwife expect from her assessment discoveries?
How would the nurse midwife proceed in light of her assessment data?