Health, Healing, and the Nursing Process 2
Part A: Revised Case Scenario
Group members: Kelly Savage, Rosemary Orumwense, Twinkle Twinkle, Jasmeen Jasmeen, Bhumika Katuwal
Assigned chronic health condition:
Grave’s Disease
Client Narrative/Story:
Helen Hill, a 35-year-old graphic designer of Irish Canadian heritage, has navigated the challenges of Graves’
Disease for one year. During her last visit, which was 6 weeks ago, Helen weighed approximately 58 kg. Despite
maintaining a stable diet, she has experienced unintentional weight loss, a common symptom of her condition,
bringing her current weight down to 48 kg. Standing at 1.68 meters tall, her Body Mass Index (BMI) has shifted
from a healthier range to a lower one, indicating this significant weight loss.
Helen is a graphic designer and her career as a graphic designer demands precision and creativity. Yet her hand
tremors and fluctuating vision have introduced barriers she continuously strives to overcome.
Recently, high blood pressure has emerged as another significant concern, further complicating her condition.
This addition underscores the necessity of a comprehensive approach to her healthcare, integrating cardiovascular
management with her ongoing thyroid disorder treatment. Socially, Helen has felt isolated due to her condition.
The physical changes, particularly the noticeable swelling in her neck and the protrusion of her eyes have led to
self-consciousness and withdrawal from social gatherings. Additionally, the unpredictable nature of her
symptoms, including severe fatigue and night sweats, has strained her relationships and ability to engage in
activities she once loved. Helen has a history of smoking, and does not drink or use recreational drugs, Helen has
also recently taken pregnancy tests due to irregular menstrual cycle, which were negative.
Despite these challenges, Helen is determined to remain independent and continue her career. She has sought
support through online communities, finding solace and understanding among others with similar experiences.
She also plays a significant role in her community, volunteering her graphic design skills to local non-profit
organizations, which not only allows her to give back but also provides a sense of purpose and belonging. Her
interest in alternative medicine has led her to explore various supplements and dietary changes to complement
her conventional treatment, seeking a more holistic approach to manage her symptoms. Helen’s resilience is
evident in her commitment to managing her condition, from adhering to a strict medication regimen to
experimenting with dietary changes and stress reduction techniques.
Issues client is experiencing related to their chronic health condition:
·Significant Weight Loss and Altered BMI: Helen’s unintentional weight/muscle loss from 58 kg to 48 kg,
despite a stable diet, significantly affects her physical health and well-being. This change has not only altered her
BMI from a healthier range to a lower one but also indicates the severity of her condition.
·High Blood Pressure (152/90 mmHg): Exacerbated by Graves’ Disease, posing additional risks to her
cardiovascular health and necessitating careful monitoring and management.
·Dizziness: The dizziness introduced by Graves’ Disease created barriers to her ability to perform better in both
her personal and professional life.
Chart Data:
Biographical Data Name: Helen Hill, Age: 35, Gender: Female, Heritage: Irish Canadian, Marital Status:
Single, Occupation: Graphic Designer.
Health History Graves’ Disease diagnosed one year ago; Anxiety; hypertension (Health history
evidence client’s BP range from 128/90 – 135/95)
Family History Mother with hyperthyroidism
Allergies NKA
Risk factors High-stress career, genetic predisposition to thyroid disorders
Physical assessment Objective Data: HR 110 bpm; BP 152/90; Visible goiter; Exophthalmos.
·Height: 5’5” inches (1.68 m)
·Past Weight: 58 kg (Before significant weight loss).
·Current Weight: 48 kg (After weight loss).
·Past BMI: Approx. 21.3
·Current BMI: Approx 17.6 (Indicative of weight loss).
Subjective Data: Client reports hand tremors, increased appetite, heat intolerance,
night sweats, excessive sweating, and sleep disturbances
Emotional
assessment
Appears anxious and fatigued; expresses feelings of isolation and frustration.
Psychosocial
assessment
Active community volunteer; challenges in social interactions; strong online support
network.
Diagnostics and lab
values
TSH: 0.009 mIU/L; Free T4: 3.4 ng/dL; Free T3: 6.8 pg/mL; TSI: 5.2 IU/L; TPOAb:
277 IU/mL
Current medications Methimazole – 20 mg, Propranolol – 80 mg, Lisinopril – 5 mg, SSRI – 2 tabs for
anxiety (Tyerman et al., 2022).
Current treatment
plans
·Medical Intervention: Focuses on managing thyroid hormone production and
symptoms through medications, regularly monitoring thyroid function to adjust
dosages.
·Nursing Intervention: Emphasizes education, medication adherence, symptom
tracking, and lifestyle adjustments for stress and symptoms management.
·Alternative Intervention: Incorporates supplements, dietary changes, and practices
like yoga and meditation, guided by consultations with experts in thyroid disorders and
alternative medicine.
Complications The potential for thyroid storm and other complications such as osteoporosis and atrial
fibrillation underscores the critical nature of consistent treatment and monitoring.
Cultural
considerations
Helen’s heritage and holistic health approach could be integrated into her care plan, if
requested, which enhances the therapeutic relationship and treatment adherence. Her
active community involvement and online support highlight the role of social support
in managing chronic conditions, contributing to her psychosocial well-being and
resilience
References
Tyerman, J., Cobbett, S., Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2022). Lewis’s
Medical-Surgical Nursing in Canada – E-Book: Assessment and Management of Clinical Problems.
Elsevier Health Sciences.
Website, N. (2023, September 25). Propranolol. nhs.uk.
Website, N. (2022b, February 2). How and when to take lisinopril. nhs.uk.
Website, N. (2021, December 17). Dosage – Selective serotonin reuptake inhibitors (SSRIs). nhs.uk.
antidepressants/dosage/
