NR 503 Week 6 Assignment-Epidemiological Analysis-Chronic Health Problem Purpose The purpose of this assignment is:
NR 503 Week 6 Assignment-Epidemiological Analysis-Chronic Health Problem
Plan
The nurse practitioner will have to address this chronic health condition. The three interventions I have selected are educating on decreasing the risk of developing the disease, conducting routine screening for those at risk, and initiating medication management for individuals diagnosed with Hashimoto’s thyroiditis. You will want to do a full history and physical on your patient. It is important to remember that other autoimmune disorders, such as rheumatoid arthritis, type 1 diabetes, or lupus, can increase the risk for the patient (Mayo Clinic, 2022). Palpation of the thyroid will be included in the examination, and the patient will be asked if they have trouble swallowing or breathing, which could indicate that the thyroid is swollen (Mayo Clinic, 2022). Since hypothyroidism can cause a slow heart rate, it will be important to note the patient’s heart rate and do a cardiac assessment. Screening for depression can help in the diagnosis, but it is also important to remember that depression alone does not give a diagnosis of a thyroid disorder. If the patient is already taking certain psychiatric medications, please remember that these medications can put the patient at risk for hypothyroidism.
Discussing the patient’s sexual history is also important, as hypothyroidism can cause a decreased libido (Mayo Clinic, 2022).
Intervention one
My first intervention would be to provide education to patients on steps that can be taken to decrease the risk of Hashimoto’s thyroiditis. Education will include environmental and social exposures such as a diet high in iodine, smoking, stress, virus exposure, and radiation exposure. Education to avoid high-iodine diets, medications, and health-related products should occur (Yoo and Chung, 2021). For example, suppose I have a patient who works in the radiology department in a CT scan. In that case, they should be encouraged to protect their body from radiation from the machines as this can lead to a higher incidence of Hashimoto’s thyroiditis (Mayo Clinic, 2022). Educating the patient on how smoking and stress can strain the immune system and increase the risk of Hashimoto’s is important (Lee, 2022). You can measure the effectiveness of the intervention by asking your patient to name three factors that can increase the risk of developing Hashimoto’s thyroiditis.
Intervention two
My second intervention will be conducting routine screening of those at-risk groups. This will focus on middle-aged individuals, especially females, at higher risk (Mayo Clinic, 2022). This intervention will include going through the signs and symptoms of Hashimoto’s thyroiditis to screen patients. Those patients’ multiple signs will require laboratory testing, including TSH, free T4, T3 levels, and thyroid antibodies (Yoo and Chung, 2021). Signs and symptoms of Hashimoto’s thyroiditis include cold intolerance, pressure in the neck, voice hoarseness, decreased energy, depression, memory/concentration difficulty, hair loss, joint pain, menstrual irregularities, sleep apnea, weight gain, slowed heart rate, and constipation (Lee, 2022). A high TSH and low T4 indicate Hashimoto’s thyroiditis (Mincer and Jialal, 2021). This intervention can be measured for effectiveness by conducting chart audits and using the data to determine how many patients have signs and symptoms, received laboratory studies, and were diagnosed with Hashimoto’s thyroiditis.
Intervention three. My third intervention is disease management with medication. Hypothyroidism is treated mainly with levothyroxine sodium (Mincer and Jialal, 2021). While dosages vary per patient, the standard dose is 1.6-1.8 mcg/kg daily (Mincer and Jialal, 2021). It is recommended that patients over 50 years be started on 25 mcg/day (Mincer and Jialal, 2021). Reevaluations should occur between six and eight weeks (Mincer and Jialal, 2021). You will need to conduct repeat laboratory studies and conduct a physical exam. It is important to know that levothyroxine sodium should not be given with iron or calcium supplements, aluminum hydroxide, or proton pump inhibitors due to their interference with medication absorption (Mincer and Jialal, 2021). It is also important to tell the patient that this medication should be taken early in the morning on an empty stomach for optimum absorption (Mincer and Jialal, 2021).
Conclusion
In conclusion, Hashimoto’s thyroiditis is the inflammation of the thyroid tissue. The thyroid is responsible for producing thyroid hormones. Inflammation can lead to damage and impact hormone production. It is seen more often in women than men. It is the most common cause of h