Lithium Induced Hypothyroidism

Student Case Development Assignments
NRSG 510 and 520
The conceptual approach allows us to focus on a specific clinical phenomenon with a total care perspective
This provides a more holistic approach and allows for broad thinking including evidence-based approaches and the consideration of alternative options when appropriate.
Biologically based life processes serve as the overall framework for categorization and study of concepts
Life processes = biological and psychosocial processes that combine to make up the entire individual. Consideration of these ever present and ongoing life processes combined with psychosocial processes provide for holistic study of the specific chosen pathological phenomenon.
Pathological phenomenon to be considered and treated include:
a. Those commonly encountered in populations with active or long-term illnesses;
b. Alterations in functionality of multiple body systems;
c. Those seen across boundaries of age, race, culture, disease entities, and clinical states;
d. Those in which NPs and CNS’s have a major role in assessing, monitoring, evaluating, and/or treating.
Biological Processes to be selectively explored:
1. Protection
a. Stress response
b. Immune competence – Disease examples include, but are not limited to, leukemia, HIV, chemotherapy, Rheumatoid arthritis, Crohn’s Disease, Lupus, effect of the eicosinoid compounds
c. Infection
d. Impaired sleep
2. Regulation
a. Metabolic alterations
i. Anorexia/malnutrition
ii. Obesity (metabolic syndrome, diabetes)
b. Thermoregulation – fever, hypothermia
c. Hormonal controls – thyroid, pituitary
3. Sensation
a. Dyspnea – CHF, valvular disease, asthma, COPD, bronchitis
b. Fatigue – HTN, fibromyalgia, Parkinson’s Disease, Multiple Sclerosis
c. Pain – acute, chronic
d. Nausea and vomiting – retching
4. Motion
a. Ischemia – stroke, CAD, PAD, TIA
5. Cognition
a. Dementia –Alzheimer’s, progressive cerebral ischemia
b. Acute confusion
6. Generative
a. Infertility – PCOS
b. Developmental – delayed puberty
c. Menopausal issues – osteoporosis

Informed by and portions adapted from the work of Virginia Carrieri-Kohlman, RN, DNSc, FAAN, Ada M. Lindsey, RN, PhD, FAAN, Claudia M. West, RN, MS and collaborators in Pathological Phenomena in Nursing (3rd edition), Saunders: St. Louis, MO. 2003.
Assignments:
#1 – Select a case scenario demonstrating impairment of biological processes related to protection.
Follow this process:
1. Describe in a short paragraph a specialty-specific case based upon a pathological process that produces an impairment in a specific biological process. The following are examples but you may select any appropriate pathology of interest to you.
a. Specific pathology related to impairment in protection
i. Pediatrics – a 2 year old child with leukemia
ii. Adult/Gero – a 70 year old woman receiving chemotherapy for colon cancer
iii. Family – A 30 year old man with acute tonsillitis/sinusitis
iv. Psych – A 22 year old college student with insomnia and severe agitation
v. Women’s health – A 30 year old woman with multiple sclerosis who is pregnant
2. Once you have described the case scenario to be considered, follow the outline below to explore the pathology :
a. Define the pathology in terms of the perspective or context from which the phenomenon will be examined.
b. Describe the prevalence of the pathology in the populations; discuss an special populations at risk due to personal, health, genetics, environmental characteristics or stressors.
c. List and briefly define risk factors—environmental, personal, genetic, developmental, cultural.
d. Discuss the pathological mechanisms involved in the development and maintenance of the malfunction.
e. State the potential detrimental outcomes associated with nontreatment or poor management of the disease process.
f. Briefly outline findings from the history and physical, psychological and social findings that may help in developing differential diagnoses- define potential differential diagnoses for your case.
g. Manifestations and surveillance – Describe both observable and subjective findings that might be present . Outline monitoring of these findings overtime as a means of evaluating the status of the disease and the patient.
h. Clinical management – state the primary objectives and strategies for management of the pathology in the case. Select treatment modalities including pharmacological agents. Give a brief rationale for your choice of specific drugs and provide the mechanism of action of each selected drug.
i. Summarize one selected article from the literature on treatment of the problem you are exploring. Describe the level of evidence the article represents. As well as research articles, survey articles and evidence-based guidelines may be used.
3. Each section of the assignment should be limited to 1-2 paragraphs. Be succinct. You may present the paper in outline form. This is not an essay or thesis. No APA formatting is required with the exception of the citation for the article you will summarize in section i.
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