WCU Nursing Discussion

Reply to one of the following prompts.

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

1. Melina is a 36-year-old female with complaints of excessive fatigue, muscle aches, difficulty sleeping, weight gain, and hair loss. She has been experiencing these symptoms for the past six months. She recently lost her job as a clerk and is under a lot of stress. She denies taking any medication and denies any medical history. She is crying at the clinic today and tells you that she does not feel right. Her labs demonstrate that her TSH is significantly elevated at 8. How will you approach and manage her complaints? What discussion will you have with the patient regarding her therapy going forward?
2. John is a 40-year-old male who has come to the clinic to review his recent lab results. He has a history of hypertension and has been on Lisinopril 20mg daily for a couple of years. He was diagnosed with “pre-diabetes” about four years ago. He states he has been trying to “eat right, exercise, and lose weight” and he has lost 5 pounds during the previous year. He hasn’t had a follow-up appointment in over a year because he was afraid to come into the office due to COVID-19. Today, his BMI is 30 and his blood pressure is 150/90. His labs show that his CBC, complete metabolic panel, and TSH are all within normal limits. His HbA1c is 8.5. What other information would you want to know about this patient? What would you recommend as your treatment plan and which clinical guidelines would you use to help develop your plan?
3. Janie is a 55-yer-old female who presents to the clinic today asking for a prescription for Synthroid to help her lose weight. She said her friend was diagnosed with “low thyroid” recently and lost a lot of weight after starting Synthroid. Janie denies complaints of fatigue, dry skin, hair loss, or constipation. Janie’s labs (CBC, complete metabolic panel, TSH, free T4) are all within normal limits. What other information would you want to know about Janie? How would you address Janie’s request?

Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas