Mrs. Juanita Manuel is a 33-year-old mother of four small children.She is a second-year student  at the local community college, within one semester of completing the requirements for an associate  degree in childcare. For the past 3 months, Juanita has been constantly hungry and has eaten more than  usual, but she has still lost 15 lb (6.8 kg). She has repeated bouts of diarrhea and often feels nauseated.  Her hands shake, she can feel her heart beating rapidly, and she finds herself laughing or crying for no  apparent reason. Mrs. Manuel makes an appointment with her family physician. The nurse at the office  completes a health history and physical assessment. When asked how she has been feeling, Mrs. Manuel  replies,”Well, I don’t know what’s wrong with me—but I keep losing weight and I cry at the drop of a hat.  I am also just so hot all the time, and I’ve never had that problem before. I hope I find out what’s wrong  and it’s nothing serious.”   The health history indicates that although her appetite has increased, Mrs. Manuel has lost 15 lb  (6.8 kg). She states that she has had diarrhea, nausea, palpitations, heat intolerance, and mood changes.  Physical assessment findings include the following: T 101°F (38.3°C), P 110, R 24, and BP 162/86. Her skin  is moist and warm, her hair thin and fine. She has visible tremors in her hands. Her eyeballs protrude, and  she is unable to close her eyelids completely. Her thyroid is enlarged and palpable. Diagnostic tests reveal  the following abnormal results: T3, 350 g/dL (normal range: 80 to 200 ng/dL), T4, 15.1 mg/dL (normal  range: 5 to 12 mg/dL). A thyroid scan demonstrates an enlarged thyroid with increased iodine uptake.  After the medical diagnosis of Graves’ disease is made, Mrs. Manuel is started on the antithyroid  medication propylthiouracil, 150 mg orally every 8 hours..  develop a care plan  Health Science Science Nursing Share QuestionEmailCopy link Comments (0)