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41 views

Care Plan

Uploaded by

okacia
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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GRAVES’ DISEASE

1200585

University of Technology, Jamaica

College of Health Sciences – Caribbean School of Nursing

Care plan: Graves’ Disease

Adult Nursing 2 NURS 3003

Prepared by: Latoya Case (1200585)

Prepared for: Mrs. Keron Jones-Fraser

Date: October 14, 2014


GRAVES DISEASE 2
1200585
Scenario

Ms. Roberts a 35 year old Administrative Assistant was newly diagnosed with Graves’ disease

and was admitted to ward 2 of Hopewell Hospital for treatment. She verbalized feeling of

anxiousness and also complained of weakness in her arms and legs, tremor in her hands,

nervousness, weight loss, frequent watery stool, fatigue, difficulty sleeping, and vision changes.

On observation and physical examination the patient has protruding eyes with reddening and

inflammation. Poor skin turgor, dry mucous membrane, enlarged non-tender thyroid and warm

flush skin with excessive sweating was noted. The patient’s vital signs are as follows:

temperature 37oC, pulse 102bpm, respiration 19bpm and blood pressure 100/60 mm/Hg. Lab

results show TSH levels were 0.2mu/L and T3 levels were 230ng/d.

Patient’s needs

1. Nutrition

2. Activity comfort and rest

3. Psychosocial

Diagnoses

1. Deficient Fluid Volume related to excessive fluid loss as evidence by frequent watery

stool, excessive sweating, weakness, poor skin turgor, dry mucous membrane, low blood

pressure, tachycardia and weight loss.

2. Fatigue related to anxiety as evidence by patient’s verbalization and sleep deprivation.

3. Anxiety related to changes in health status as evidence by elevated pulse rate, tremor in

hands, patients verbalization of feeling anxious and difficulty sleeping.


GRAVES DISEASE 3
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Assessment Diagnosis Patient outcome Implementation Rationale Evaluation
Subjective Deficit Fluid Patient will display 1. Monitor blood pressure and 1. Tachycardia is a defense Goal met: patient

Patient verbalized: Volume related to signs of adequate pulse rate. mechanism to maintain displayed signs of

-Frequent watery stool excessive fluid hydration at the end cardiac output due to adequate hydration at

-weakness loss as evidence of the eight hour shift 2. Encourage fluid intake by hypovolemia. Hypotension is the end of the eight

-fatigue by frequent watery following nursing offering fluids regularly to a hall mark of pressure of hour shift following

-weight loss stool, excessive and collaborative patient. hypovolemia. nursing and

sweating, interventions, as collaborative

Objective weakness, poor evidence by normal 3. Monitor input and output. 2. To maintain adequate interventions as

-Frequent watery stool skin turgor skin turgor, moist hydration. evidence by normal

-Excessive sweating increased pulse mucous membrane, 4. Reassess skin turgor and skin turgor, moist

-Poor skin turgor rate, weight loss stable blood pressure moisture of mucous 3. To evaluate a patient’s t mucous membrane,

-Increased pulse rate and dry mucous and pulse. membrane. fluid and electrolyte balance stable blood pressure

-Dry mucous membrane. and allow for prompt and pulse.

membrane 5. Administer IV fluid and intervention to correct

-pulse 102bpm electrolyte as indicated. imbalance.

-blood pressure 100/50

4. To detect changes in

6.Monitor patient for excess hydration status.


GRAVES DISEASE 4
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fluid volume during the

treatment of deficient fluid 5. To maintain adequate tissue

volume perfusion.

6. To prevent fluid overload.


GRAVES DISEASE 5
1200585
References

Brunner & Suddarth’s (2010). Medical surgical Nursing, 12th ed. Lippincott, Williams & Wilkins.

Carpenito, L.J. (2009) Nursing diagnosis: application to clinical practice. Lippincott, Williams &
Wilkins.

Medline Plus (2014) Femur fracture repair – discharge. Retrieved September 4, 2014 from:

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000166.htm

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