You are working as a clinic nurse and while away from your desk, you have these client messages. 58 year old diagnosed with diabetes, reporting a fasting glucose of 112 and requesting prescription refills for their oral diabetic medication

You are working as a clinic nurse and while away from your desk, you have these client messages.

1. 58 year old diagnosed with diabetes, reporting a fasting glucose of 112 and requesting prescription refills for their oral diabetic medication
2. A 64 year old diagnosed with Cushing’s syndrome reporting a pulse of 74, blood pressure of 150/90 and blood glucose of 210
3. A 72 year old diagnosed with hypothyroidism reporting a pulse of 78, blood pressure of 128/70, and requesting prescriptions refills for the thyroid medication
4. A 45 year old diagnosed with hyperthyroidism, reporting a pulse of 89, blood pressure of 130/78

Identify who should be called back first and why

ANSWER

Prioritizing Clinic Call-backs: Identifying Urgency in Diabetes, Cushing’s Syndrome, Hypothyroidism, and Hyperthyroidism Cases

Introduction

As a clinic nurse, effective triage and prioritization of client messages is crucial to ensure timely and appropriate healthcare management. In this scenario, we have received messages from four clients, each with different medical conditions and presenting with varying vital signs and medication refill requests. In order to optimize patient care and respond promptly, it is important to determine who should be called back first based on the urgency of their situation. In this essay, we will analyze the provided information and identify the client who requires the most immediate attention.

58-year-old diagnosed with diabetes

This client reports a fasting glucose level of 112 and requests prescription refills for their oral diabetic medication. While a fasting glucose level of 112 is slightly above the normal range (70-99 mg/dL), it does not indicate immediate danger or acute complications. However, since diabetes management relies on maintaining stable blood glucose levels, it is important to address their medication refill request in a timely manner (Mathew, 2023). Therefore, this client’s call-back can be scheduled soon, but it does not require immediate attention.

64-year-old diagnosed with Cushing’s syndrome

The client with Cushing’s syndrome reports a pulse of 74, blood pressure of 150/90, and blood glucose of 210. Cushing’s syndrome is characterized by an excess of cortisol in the body, which can lead to various complications, including hypertension and hyperglycemia. The elevated blood pressure (150/90) and blood glucose level (210) suggest potential acute symptoms or a need for medication adjustment. Hypertension and uncontrolled blood glucose can have serious implications for this client’s overall health (Whitworth et al., 2005). Therefore, the client with Cushing’s syndrome should be called back immediately to assess their symptoms, provide guidance, and potentially adjust their treatment plan.

72-year-old diagnosed with hypothyroidism

This client reports a pulse of 78, blood pressure of 128/70, and requests prescription refills for their thyroid medication. Hypothyroidism is a condition characterized by an underactive thyroid gland, leading to a slower metabolic rate. The vital signs provided by the client, including a normal pulse and blood pressure, do not indicate an immediate medical emergency (Berta et al., 2019). However, it is important to address their medication refill request in a timely manner to ensure continuity of treatment. The call-back for this client can be scheduled relatively soon, but it does not require immediate attention.

45-year-old diagnosed with hyperthyroidism

The client with hyperthyroidism reports a pulse of 89, blood pressure of 130/78, and no specific medication requests. Hyperthyroidism is characterized by an overactive thyroid gland, resulting in an increased metabolic rate. The client’s vital signs, including a slightly elevated pulse and normal blood pressure, do not indicate an immediate medical emergency. Since there are no urgent medication refill requests, the call-back for this client can be scheduled based on the clinic’s availability, but it does not require immediate attention.

Conclusion

Based on the information provided, the client with Cushing’s syndrome should be called back first due to their elevated blood pressure and blood glucose levels, indicating potential acute symptoms and the need for immediate medical attention. Prioritizing their case will enable timely assessment, appropriate intervention, and management of their condition. However, it is important to address the needs of all clients in a timely manner to ensure continuity of care and promote their overall well-being.

References

Berta, E., Lengyel, I., Halmi, S., Zrínyi, M., Erdei, A., Harangi, M., Páll, D., Nagy, E., & Bodor, M. (2019). Hypertension in Thyroid Disorders. Frontiers in Endocrinology, 10. https://doi.org/10.3389/fendo.2019.00482 

Mathew, T. K. (2023, April 23). Blood Glucose Monitoring. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK555976/ 

Whitworth, J. A., Williamson, P. R., Mangos, G., & Kelly, J. M. (2005). Cardiovascular consequences of cortisol excess. Vascular Health and Risk Management, 1(4), 291–299. https://doi.org/10.2147/vhrm.2005.1.4.291