Abnormal blood pressure response to activity Failure to increase BP with activity Goals and Outcomes The nursing goals are to reduce the effects of inactivity, promote optimal physical activity, and assist the patient with maintaining a satisfactory quality of life. Patient will identify factors that aggravate activity intolerance. Patient will verbalize and use energy-conservation techniques.
Pathophysiology of Thyroid Carcinoma Thyroid carcinoma usually capture radioactive iodine than normal thyroid gland is located in the surroundings. Therefore, when done scintiscan, nodules will appear as an area with less retrieval, a cold lesion. Other diagnostic techniques that can be used for differential diagnosis of thyroid nodules are thyroid Ecography.
This technique allows to distinguish carefully between solid masses and cystic masses. Thyroid carcinoma usually solid, while the cystic mass is usually a benign cyst. Thyroid carcinoma should be suspected based on clinical signs if there is only one palpable nodules, hard, basically can not be moved, and is associated with satellite lymphadenopathy.
It was generally agreed that clinical thyroid cancer can be divided into a large group of well differentiated neoplasms, with a slow growth rate and high cure is possible, and a small group of anaplastic tumor with possible fatal.
There are four types of thyroid cancer according to morphologic and biological properties: In multinodular goiter, cancer in the form of "dominant nodule" bigger, louder and clear from the surroundings.
Rarely, will hemorrhage, necrosis and cyst formation in malignant nodules but on thyroid ultrasonography, there will be a clearly bounded internal echo is useful for semi malignant cystic lesions of "pure cysts" were not malignant. Finally, papillary carcinoma can be found accidentally as a microscopic focus of cancer in the middle of the gland removed for other reasons such as: Graves' disease or multinodular goitre.
Microscopically, the tumor is composed of a single layer of thyroid cells organized in "vascular stalk", with protrusion of the optic disc into the microscopic space such as a cyst. Cell nuclei are large and often contain inclusion bodies pale nucleus intra clear and glassy.
This cancer is usually spread by metastasis in the gland and the thyroid gland invasion and local lymph nodes. In elderly patients, they can be more aggressive and invade locally into the muscle and trachea.
In stage further, they can spread to the lungs. Death is usually due to local disease, with invasion into the neck, more rarely death could be due to extensive pulmonary metastases. In some elderly patients, a slow-growing papillary carcinoma will begin to grow rapidly and transform into anaplastic carcinoma.
Further anaplastic changes are another cause of death from papillary carcinoma, papillary carcinoma secreting lots of thyroglobulin, which can be used as a sign of recurrence or metastasis of cancer.
Follicular carcinoma is characterized by the persistence of small follicles despite bad colloid formation. Indeed, follicular carcinoma can not be distinguished from follicular adenomas except with capsule invasion or vascular invasion.
The tumor is slightly more aggressive than papillary carcinoma and spreads either by local invasion or lymph node invasion of blood vessels accompanied by distant metastases to bone or lung. Microscopically, these cells are cuboidal shaped with large nuclei were irregular around the follicle, often containing colloid.
These tumors are often still have the ability to concentrate radioactive iodine to form tiroglubulin and rarely, to synthesize T3 and T4.
Thus, the function of the thyroid cancer that is almost always a rare follicular carcinoma. These characteristics make these tumors more it is likely to give good results against radioactive iodine treatment. In untreated patients, death due to local extension or distant metastases because the flow of blood with extensive involvement of the bones, lungs, and viscera.
A variant of follicular carcinoma is carcinoma "Hurthle cell" which is characterized by cells alone great with pink cytoplasm containing mitochondria. They behave more like papillary carcinoma unless they are rare radioiodine uptake. Papillary and follicular carcinoma of the mixture is more like a papillary carcinoma.
Thyroglobulin secretion produced by follicular carcinoma can be used to follow the course of the disease.Nursing Diagnosis for Congestive Heart Failure (CHF) Activity Intolerance related to imbalance between oxygen supply. General weakness, long bedrest / immobilized.
Nursing Care Plan Activity Intolerance Definition:Insufficient physiological or psychological energy to endure or complete required or desired daily activities Defining Characteristics Abnormal blood pressure and heart rate response to activity, Electrocardiographic changes reflecting arrhythmias and/or ischemia,Exertional discomfort and/or dyspnea,Verbal report of fatigue and/or weakness.
Nursing Care Plan A Client with Hypothyroidism Jane Lee is a year-old retired nurse living with her husband and daughter on a farm that has been in the family for four genera- activity intolerance EXPECTED OUTCOMES •Regain normal bowel elimination patterns, having a soft.
Nursing Interventions Scientific Rationale; Determine patient's perception of causes of fatigue or activity intolerance.
Assessment guides treatment. Jan 18, · NCP for Activity Intolerance Activity Intolerance (Diagnosis) It is a condition in which a person has insufficient physical or psychological energy, to endure or perform desired physical activities. Nursing Diagnosis: Activity Intolerance R/T difficulty breathing State subjective and objective information Expected Outcomes: Patient will achieve a measurable increase in activity tolerance as evidenced by reduced fatigue and weakness and by vital signs within acceptable limits during physical activity by (date).