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NSG diagnosis

  1. disturbed sensory perception related to blurred vision:

  • monitor visual acuity, photophobia, integrity of cornea and lid closure— the corneal is at risk for dryness, injury, conjunctivitis, and corneal infections. Injury and infection of the cornea can result in further loss of visual acuity

  • use tinted glasses or shields to protect pts eye— decrease risk of injury to eyes

  • cover or tape pt eyelids at night if they cant close— promote comfort

  • elevate head of bed to 45 degrees— decrease periorbital oedema that can further compromise vision

  • instruct pt to report any pain or changes in vision promptly— allow immediate care for problems reported by pt and minimise risk of further vision loss

  1. imbalanced nutrition, less than body requirements related to high metabolic rate

  • monitor daily weight at the same time every day and keep a record of results— the inability to meet metabolic demands results in loss of body weight. Regular monitoring detects continued weight loss

  • refer pt to dietician to offer a diet higher in protein and carbs as well as well-balanced snacks in between meals— increased nutrients are needed to meet metabolic demands. Small frequent meals will increase food intake

  • monitor intake and outake chart strictly— to monitor fluid balance and note nausea, vomiting, diarrhoea, and identify precipitating factors for diarrhoea stools

  • monitor for nutritional status through lab test results— a negative nitrogen balance indicates a catabolic state in which protein is lost and metabolic demands are not being met


pt education:

  1. teach medication indication, side effects, and the need for continued medical care

  2. provide postoperative wound care if pt had thyroidectomy done

  3. teach pt to detect hypothyroidism symptoms if they are on radioactive iodine therapy


test for Diabetes Mellitus:

  1. HbA1c: measures average amount of glucose attached to haemoglobin in red blood cell over past three months.

  2. OGTT (oral glucose tolerance test): performed in morning, at least 3 days after unrestricted diet and usual physical activity. Pt to drink 75g of glucose in water within 5mins after which they must not eat and should limit physical activities. A second blood sample is taken two hours after the glucose drink to complete the test.

  3. fasting plasma glucose: measures sugar level in blood. Blood sample is drawn and pt must refrain from eating or drinking anything except water for 8-12 hours beforehand.


therapeutic effects of metformin:

  1. monitor blood glucose and HbA1c levels. Optimum glycaemia control indicated the effectiveness of metformin

  2. monitor signs and symptoms of hyperglycaemia such as fatigue and polyuria. Metformin dose may need to be increased if signs of hyperglycaemia is present


MOA of insulin:

  1. inhibits hepatic blood glucose production and enhances protein synthesis and conversion of excess glucose into fats

  2. reduces blood glucose levels by stimulating glucose uptake by skeletal muscles and fats


treatment for HYPOTHYROIDISM

  • maintain patent airway

  • maintain optimum breathing, administer oxygen and mechanical ventilation when necessary

  • maintain fluid and electrolytes, acid-base balance and maintain cardiovascular disease


functions of thyroid hormones:

  1. foetal development (brain development and skeletal maturation)

  2. utilization of vitamins

  3. control metabolic rate of call cells and digestive processes

  4. regulate cholesterol, protein and fat metabolism

  5. promotes pituitary secretion of growth hormone and gonadotrophins

  6. affect respiratory rate and drive

  7. facilitate in increasing red blood cells production

  8. skip ;p