There is no assessment that may be performed in order to confirm chronic fatigue syndrome in a patient. For the reason that the indicators of chronic fatigue syndrome can imitate numerous other health issues, VG may require patience while waiting for the judgment. In VG’s case, several other complications may appear. Chronic fatigue can be instigated by sleeping pattern disorders. A sleep investigation can regulate if VG’s rest is being distressed by disorders such as disruptive sleep apnea or insomnia. Fatigue is a rather prevalent warning sign in numerous medical situations, such as underactive thyroid, anemia, and diabetes. Laboratory examinations can check VG’s blood for evidence of some of the previously mentioned syndromes (Fadeyev, 2012). Fatigue is also an indication of a diversity of probable mental health complications, such as nervousness, schizophrenia, and depression. In VG’s case, the nurse will have to deal with a pregnant woman and will have to take into account the complications connected to thyroid.
Thyroid stimulating hormone is generated by the pituitary gland. Moreover, if VG’s body does not obtain sufficient thyroid hormones, the signs of the insufficiency are sent to her thyroid gland and pituitary gland. As the level of thyroid stimulating hormone upsurges and the thyroid levels decline, the subsequent illness may be hypothyroidism. Excessive levels of thyroid stimulating a hormone in VG may be the first signal of secondary effects or indications of hypothyroidism discovered by means of blood tests for thyroid illness (Hedberg & Cook, 2015). The assessments will reveal high TSH levels. Furthermore, these evaluations might discover low levels of T3 and T4 thyroid hormones. Furthermore, VG’s thyroid hormones may be in the low-normal range, but TSH will still be represented by high numbers. This may designate a mild form of hypothyroidism.
I would recommend increasing the thyroid drug dosage increasingly in an incremental manner until the possibility to find the optimal dosage for VG will appear. I will have to monitor T3 (including reverse T3), T4, and thyroid antibodies. The most important task will be to monitor the real-time symptoms. I would implement mild dosages first, and increase them gradually in order to prevent an adverse reaction in VG. The drug that I would prefer prescribing is Cytomel. It is a T3 medication that has active T3 in it. The possible complications might include excessive heart stimulus and heart palpitations. I would recommend VG a starting dosage of 25 mcg daily. The diurnal dosage then may be amplified by up to 25 mcg. A typical maintenance dosage is 25 to 75 mcg on a daily basis. In VG’s case, it is critical to have a moderate start.
If VG becomes pregnant, I would recommend her having a TSH and an estimation of thyroxine level. If at all possible, VG should be evaluated before becoming pregnant at prenatal therapy and immediately when she knows she is pregnant. I recommend doing this for the reason that women with hyperthyroidism while expecting a child are at an improved risk for facing any of the signs and indicators of hyperthyroidism. Owing to its latent risks, the main objective of VG’s treatment is to utilize the minimal amount of antithyroid medications (Lazarus, Soldin, & Evans, 2011). Another goal is to maintain her T3 and T4 levels at the upper level of normal while maintaining her TSH at the lowest levels possible. When hormones fluctuate within the anticipated levels, medication doses can be lessened. This method regulates hyperthyroidism while lessening the variations of a baby developing hypothyroidism.
References
Fadeyev, V. V. (2012). Management of thyroid dysfunction during pregnancy and postpartum:an Endocrine Society clinical practice guideline. Clinical and Experimental Thyroidology, 8(4), 8-11. Web.
Hedberg, N. R., & Cook, D. (2015). The complete thyroid health & diet guide: Understanding and managing thyroid disease. Toronto: Robert Rose Incorporated.
Lazarus, J. H., Soldin, O. P., & Evans, C. (2011). Assessing thyroid function in pregnancy. Thyroid Function Testing Endocrine Updates, 209-233. Web.