Case Study 1: Hyperthyroid
Shirley, a 34 year old woman comes to the physician’s office complaining of feeling jittery all
the time and suffering from intolerance to heat. The physician rules out menopause because
Shirley is young. He suspects hyperthyroid disease.
What other symptoms will the physician look for in Shirley to suggest a diagnosis of
hyperthyroid disease?
What tests are performed to confirm the diagnosis?
The physician decides to treat conservatively using medications. List the drugs and explain the
action of medication given to treat hyperthyroidism.
How will blood tests be used to follow and evaluate the effect of medication?
Medication alone is not sufficient and so Shirley is scheduled for surgery. What are the surgical
options for Shirley? Explain assessment observations for possible postoperative complications
from a thyroidectomy.
What post-operative teaching about head control will Shirley need?
What teaching topics are necessary to prepare Shirley for life adjustment after thyroidectomy?
Explain the symptoms and treatment for thyroid storm.
List symptoms the nurse will observe if the parathyroid gland is injured or removed during
surgery
Case Study 2: Hypo Parathyroid Disease
During a postoperative checkup Shirley demonstrates a positive Chvosteck’s sign. The physician
next tests for Trousseau’s sign, and then orders a bone scan.
How did Shirley develop hypoparathyroid disease?
Explain Chvosteck and Trusseau’s signs.
Why did the physician order a bone scan?
The physician may require Shirley to wear a Holter Monitor because….?
What is the function of parathyroid hormone? How is this related to calcium?
List blood studies the physician will use to follow parathyroid function.
What is the purpose of Shirley taking Vitamin D and Phosphate-binding drugs?
Describe patient teaching needed when taking Phosphate-binding drugs.
Case Study 3: Diabetes Mellitus
I. Explain the physiology that creates the three symptoms of diabetes.
II. What is the function of each of these pancreas cells?
Alpha, Beta, Delta
III. A client is admitted to the hospital with diabetic ketoacidosis. The nurse understands that the
elevated ketones present in this disease is caused by the incomplete oxidation of
______________
IV. List five symptoms of hypoglycemia AND five symptoms of hyperglycermia.
V. Fill in the insulin times on this chart.
Insulin
Onset
Peak
Duration
Regular
NPH
Lantus
VI. What is an appropriate nursing action when patient’s blood sugar test is 50?
VII. Contrast DKA and HHNS. Compare means how are they different.
DKA
HHNS
Cause
Blood sugar level
Population who has
Treatment in order of
complication
Teaching
priority to prevent
VIII. What is the triad of treatment for Diabetes Mellitus?
IX. Describe Dawn phenomenon and Somogi phenomenon.