SOLVED249

Endocrine/Renal: This patient displays signs of severe primary hypothyroidism as indicated by elevated TSH (thyroid-stimulating hormone) levels Which could lead to Myxedema coma and multiple organ failure, and low free T4 levels, and an acute kidney injury with elevated creatinine, decreased estimated glomerular filtration rate (eGFR), mild transaminitis symptoms possibly relating to liver congestion due to volume overload; hypothyroidism could contribute to fluid retention further compromising renal functioning and worsening the situation further. Cardiovascular: This patient’s cardiovascular system has been severely compromised. With history of coronary artery disease, myocardial infarction and peripheral vascular disease in the past; both chest X-ray and CT scan evidence cardiomegaly, bibasilar airspace consistent with alveolar edema as well as tiny bilateral pleural effusions on CT scan images; while their echocardiogram showed borderline dilation of left ventricle; abnormalities to both mitral valves as well as petricardial effusion; there were signs of early hemodynamic effects of pericardial fluid on right sided chambers. She was determined to be hemodynamically stable with a pericardial effusion. This patient’s cardiac dysfunction was diastolic in nature, suggested by an ejection fraction of 66% to 70%. The above mentioned hormone replacement therapy should improve her mild diastolic hypotension. Neurologic: If the patient exhibits
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HEALTH SCIENCE
NURSING

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