• Discuss the care of the client using ONE of the principles of empowerment,
collaborative decision making OR diversity
• From the case study provided identify the clients’ stage on the illness trajectory and provide rationale for your decision.
• Critique the relevance and application of the chosen principle to your case study, providing specific examples of the nursing care you would provide and evidence to
support this.
• Consider the expected outcomes of your interventions and highlight potential barriers for the nurse/client/family in relation to the principle discussed and the care
approach suggested.
• Correct APA referencing must be used to support all factual statements.
• Please use an essay style for this paper.
Sienna, is a 39 year old woman of Asian decent, who lives in an inner suburb of Sydney with her two teenage children. Since her divorce some eight years ago, Sienna
has been under constant pressure to hold down two jobs in the hospitality industry in order to pay for her children’s education.
Lately, she has been complaining to her children that she is always tired, probably because she is waking many times during the night and sweating. She thinks she
might be starting menopause as she has not menstruated for the last two months. a few months later she complains of a sore throat and makes an appointment with her
local doctor.
The doctor examines her and includes these points in his assessment findings:
• Appears anxious/restless
• Pulse 135
• BP 110/70
• Mild stare
• Mild exophthalmos
• Warm to touch and diaphoresis of palms
• Slight tremor of outstretched arms
• eyelid lag
• Thin, brittle nails
• Thyroid: firm smooth symmetrical and slightly enlarged
The doctor orders a blood test for thyroid stimulation hormone (TSH) and serum free thyroxine FT4 and total free triiodothyronine FT3 levels. He also orders an ECG and
radioactive iodine uptake ( RAIU) test.
Sienna’s results show a decreased TSH and increased FT4 and T3, this signifies hyperthyroidism. The results of the RAIU indicate to the doctor that Sienna has Graves’
disease.
Graves’ disease is an autoimmune disease. it is thought that infection, insufficient iodine in the diet and stressful life events may contribute to the onset of this
disease. The person develops thyroid antibodies, which stimulate thyroxin production and secretion. Graves’ disease also causes a growth in the thyroid gland.
The choice of three treatments is offered to Sienna:
1. anti-thyroid medication,
2. radioactive iodine treatment
3. surgery.
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