Transsphenoidal Hypophysectomy Essay
Patient Name: Owen Joyce
Hospital No.: 11/ s66/22
Consultations: Dennis Eugene
Procedures: Transsphenoidal Hypophysectomy
Admitting diagnosis: Cushing’s syndrome
HISTORY: The patient is a 45-year-old female who has Cushing’s syndrome. (P) She was diagnosed with Cushing’s syndrome three years ago, with an etiology of glucocorticoid abuse and misuse of dermatological products and bleaching medications, as well as elevated cortisol production due to adrenal cortex hyperplasia and a pituitary tumor that secretes ACTH and stimulates the adrenal cortex to increase hormone secretion (Hinkle & Cheever, 2018). (P) She also presented with central obesity, a buffalo hump in the shoulder and supraclavicular regions, abdominal fat deposits, and very slender limbs. Other symptoms are (P) her skin being very thin and sensitive, with obvious bruises and purple striae. (P) She complains of weariness and weakness. Changes in cortisol production during the day also impair sleep causing (P) her insomnia.
ADMISSION LABORATORY DATA: Sodium 128, potassium 5.6, chloride 114, glucose 111 mmol/dl Urinalysis results were negative. Hemoglobin level of 12.3, hematocrit of 44.5, white blood cell count of 15,400, and platelet count of 14,000. To confirm that (P) she had a pituitary tumor, a CRH stimulation test and a high-dose dexamethasone suppression test were performed (Cohen et al., 2019).
HOSPITAL COURSE: The patient was brought to the operating room by the (N) nurse, and a (N) transsphenoidal hypophysectomy was done. The patient’s intraoperative course was stable, with (P) her incision site clean and dry. The (N) anesthesiologist administered one point of packed red cells intraoperatively to the patient. The patient was discharged for further evaluation at the (N) surgeon’s clinic.
DISCHARGE DIAGNOSIS: Cushing’s syndrome
- fluconazole aminoglutethimid 200mg OD
- Hydrocortisone 20 mg TDS
- Paracetamol 500 mg TDS
Cohen, A. C., Goldney, D. C., Danilowicz, K., Manavela, M., Rossi, M. A., Gómez, R. M., Cross, G. E., & Bruno, O. D. (2019). Long-term outcome after bilateral adrenalectomy in Cushing’s disease with a focus on Nelson’s syndrome. Archives of Endocrinology and Metabolism, 63(5), 470–477. https://doi.org/10.20945/2359-3997000000144
Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of Medical-Surgical Nursing. Wolters Kluwer.
This discussion question will have you demonstrate your knowledge of the medical terms, understanding of the use of nouns, pronouns, and adjective, by providing a section for a summary hospital discharge report. (See page 104 & 105 for examples) Research a medical problem that would be treated in a hospital and write 2-3 paragraphs to your classmates describing the â€œevents that occurred during the patients stay,â€ using 20 of the words in Section 1, 2, 3, and 4 of the textbook under â€œMedical Spelling.â€ You must highlight these words in yellow. You will also need to underline at least ten nouns, ten pronouns, and ten adjectives. Place a (n), (pn) or (a) before the word to identify them. [n=noun, pn=pronoun, a=adjective]. Provide one reference to support your discussion.
Your classmates must respond to your post with a question, suggested treatment, or explanation to the patient in nonmedical terms. The response must have the medical term used highlighted or the non-medical word/phrase highlighted in yellow.