Question

(Nutrition) Nurses complete an assessment of each new patient/client. They are often the professional who determines that there may be a nutritional deficiency. List one symptom from a head to toe exam or patient's history that may indicate a possible vitamin or mineral deficiency. List the nutrient as well. Remember, a sign or symptom would not be enough to diagnose a vitamin deficiency. Further testing such as blood work would be required.

Answer 1

Iodine deficiency is one of the most common deficiencies that we can find very often.

The main symptom that we can observe for this type of patient during the head to toe physical examination is the swelling at the front of the neck. This is known as goiter.Usually the iodine that we consume through the food is used to make thyroid hormones by the thyroid gland.This happens due to the the stimuli from the pitutary gland.This stimuli is known as the thyroid stimulating hormone (TSH).Since there is no iodine, the production of thyroid hormones is not happening .As a result there will be increased amount of TSH in the blood.Due to this the thyroid gland works harder and harder to produce enough thyroid hormone .This makes the enlargement of the thyroid gland and we call it goiter.

From history we can understand that the patient has unexpected weight loss.This happens due to the absence of the thyroid hormone .Metabolism does not take place and the food that these people eat does not store as fat.(Thyroid hormones helps the metabolism of the food )

The other information that we get from the client is the hair loss,cold intolerance,decreased ability to learn and to remember things,irregular menstrual cycle.

From the physical examination we can also find that the client has dry skin,patient will have bradycardia,

Also patient says thecomplaints of fatigue,dizziness and weakness.

There are certain investigations that we have to do to diagnose the condition.

1 Check the blood sample for Thyroxine level  and TSH( decreased thyroid hormone value and increased TSH value)

2 .24 hour urine sample test for iodine

3.Iodine patch test is performed by painting the iodine and if there is deficiency this painted iodine will disappear.

4.Protein bound iodine test