1.
Case Study Chapter 30
Mr. C. has been experiencing severe thirst, which he reports “makes me go to the bathroom all the time, it
seems.” He is also dehydrated, despite the large amounts of water he has been drinking. He is diagnosed with
diabetes insipidus.
1. What two drugs may be used to treat diabetes insipidus?
Hormonal drug called desmopressin can be given as it is the replacement for the deficient enzyme antidiuretic
hormone in the patients. Other than this a non-hormonal drug called hydrochlorothyozide can be given. It
lowers the blood pressure and reduces the extra fluid in the body in case of kidney failure. Which is the main
problem in diabetes insipidus patients.
2.
Question 2
5 Points
2. Explain the concept of “euthyroid” as it would relate to Goldie’s condition.
The term "euthyroid" refers to a thyroid gland that is functioning "true," producing adequate amounts of
thyroid hormone in response to stimuli from the pituitary. Euthyroid is also used to categorize patients whose
laboratory results for assessing thyroid function fall within the laboratory's reference interval (normal test
result).
It's hard to tell if you have thyroid abnormalities. You might feel run down and tired, or have what is known as
"brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious,
or sweat a lot more than usual. All of these are common symptoms of thyroid disorders. The thyroid gland
regulates many processes within the body, and women are particularly likely to have disorders that affect the
function of this essential gland. Recognizing and treating these conditions is critical for optimum health and
preventing long-term health problems.
The thyroid gland is located in front of the neck. It has right and left lobes that confer a butterfly-shaped
appearance. The hormones produced by this gland control the body’s metabolism, or the processes by which
the body uses energy. Disorders that affect thyroid function can either speed up or slow down metabolic
processes, which can lead to a wide range of symptoms.
3.
Question 3
5 Points
4. Following your explanation, Mr. C. says, “Okay, okay, but what does it do for me?” Explain the physical
improvements Mr. C. should be able to see.
Physically smooth muscle contraction is observed. urination would become less frequent. Might lose weight.
but it depends from person to person.
4.
Question 4
5 Points
3.The physician decides that Mr. C. should do well with vasopressin (Pitressin) therapy. Indicate how you
would describe the treatment and its therapeutic effects (that is, how it mimics the natural hormone) to the
patient.
Vasopressin is a syntheic hormone resembling the anti-diuretic hormone that are normally secreted by the
pituitary gland.It acts on the kidneys and blood vessels. It increases water reabsorption at the collecing ducts in
the kidney and increases the blood pressure by narrowing the blood vessels.At higher doses, it promotes
smooth muscle contraction. It is generally injected into the vein through IV. Around 5-10 units
intramuscularly, 2-4 times a day.. Frequent blood tests and ECG is suggested during the therapy.
5.
Question 5
5 Points
2.What are the possible cautions to the use of these drugs?
Desmopressin- Causes low sodium levels. Very low levels lead to seizures, breathing trouble and death. So,
counter medicine for increse in sodium levels is suggested.
Hydrochlorothyozide- Causes dehydration leading to severe sweating, vomitting and diarrhea. It may decrease
potassium levels in the body.Hence, food consumption of high potassium content is suggested.
6.
Question 6
5 Points
Case Study Chapter 31
Goldie, a 38-year-old teacher, has come to the clinic complaining of having “no energy or appetite” and yet her
weight has increased by 15 pounds in the last month. You note that her hair is thin and her skin is dull.
Laboratory work reveals an elevated level of thyroid stimulating hormone (TSH). A diagnosis of
hypothyroidism is made.
1. What medication do you expect to be ordered for Goldie?
An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called
levothyroxine. Levothyroxine replaces the thyroxine hormone, which your thyroid does not make enough of.
You'll initially have regular blood tests until the correct dose of levothyroxine is reached. This can take a little
while to get right. You may start on a low dose of levothyroxine, which may be increased gradually, depending
on how your body responds. Some people start to feel better soon after beginning treatment, while others don't
notice an improvement in their symptoms for several months. Once you're taking the correct dose, you'll
usually have a blood test once a year to monitor your hormone levels. If blood tests suggest you may have an
underactive thyroid, but you don't have any symptoms or they're very mild, you may not need any treatment. In
these cases, the doctor will usually monitor your hormone levels every few months and prescribe
levothyroxine if you develop symptoms.
7.
Question 7
5 Points
3. One month after therapy has begun, Goldie calls the office to complain that she “can’t sleep at all” since she
started taking the medication. She says she tries to take it at the same time every morning but often forgets and
takes it at dinnertime. What teaching, if any, does she need to help her with this problem?
