CASE SCENARIO: You are assigned to care for a 30 y.o. patient who was rushed to the hospital yesterday because of syncope. During your history taking you noted that the client has just completed his 28 days of radiation therapy for his diagnosed nasopharyngeal cancer. Family noted his abrupt weight loss, bouts of hand tremors, weakness and feeling sleepy all the time even before the completion of the radiation therapy which they failed to report because they felt that it must be due to the radiation therapy and the changes it has brought to him such as xerostomia, mucositis and dysphagia which lead to poor intake. However, they said that the symptoms of hand tremors, weakness and increased sleeping hours remained even after radiation therapy. During your physical examination, you noted the following: VS: BP-90/50, HR-115/min., RR-25/min., T-36.50C; He was lethargic, with cool skin which was dry, coarse and having poor turgor; There is obvious hairloss with a lot of the strands coming off as you assessed the head, equal but slightly sluggish pupillary response, pale nailbeds, pale conjunctiva, pale lips and oral mucosal membranes. His breathing was equal but appears to be very shallow. Her peripheral pulses are slow and weak. You noted that the patient had pain evidenced by grimacing throughout examination. His muscle strength was 2/5. Laboratory shows the following: Hgb.= 11 mg/dl, Hct=34 %, WBC=5,000cumm; Low: T3,T4 and TSH; Ca= 3.5 mg/dL; Mg=1.5mg/dL; K=5.5mEq/L,Na=120mEq/L; ECG shows Tachyarrhythmia.
1. Given the assessment cues and the treatment modality the patient had, what do you is the reason behind client’s current condition and explain.
2. Show the pathophysiologic explanation behind client’s condition using a pathophysiologic diagram.
3. Show your problem list for this patient. List them according to priority and give rationale for selection of your number 1 priority.