NR 503 Week 6 Assignment-Epidemiological Analysis-Chronic Health Problem

For this paper, I will discuss a chronic health disease called Hashimoto’s thyroiditis. I will define, describe, describe signs and symptoms, and describe disease statistics. I will provide current surveillance methods and mandated reporting processes related to the disease. I will conduct a descriptive epidemiology analysis of the health condition, including what, who, where, when, and why. I will explain how the disease is diagnosed and current national guidelines. I will review a screening test’s sensitivity, specificity, predictive value, and cost. I will provide a plan of how a nurse practitioner will address this chronic health condition and give three specific interventions. Need help with your assignment ? Reach out to us. We offer excellent services.

Background and Significance

 Hashimoto’s thyroiditis is also known as chronic lymphocytic or chronic autoimmune thyroiditis. It is an autoimmune disorder where cell and antibody-mediated immune processes destroy the thyroid cells (Mincer and Jialal, 2021). The thyroid is found in the lower front of the neck and is responsible for making thyroid hormones (American Thyroid Association, 2022). The hormones produced are excreted in the blood and carried to other tissues. (American Thyroid Association, 2022). In Hashimoto’s thyroiditis, antithyroid antibodies begin to attack the thyroid tissue and lead to fibrosis (Mincer and Jialal, 2021). This leads to a decrease in the hormone production and leads to hypothyroidism. Laboratory results will show an elevated thyroid-stimulating hormone (TSH) with normal to low free thyroxine (fT4) levels (Mincer and Jialal, 2021). In the early course of the disease, the patient may have signs, symptoms, and laboratory findings of hyperthyroidism or normal values due to the irregular destruction of the thyroid gland cells (Mincer and Jialal, 2021). Signs and symptoms of the disease may vary depending on the person. Common symptoms include goiters, tiredness, brittle nails, puffy face, joint pain, problems with memory or concentration, muscle weakness, weight gain, sensitivity to temperatures, depression, hair/skin changes, rapid heart rate, weight loss, tremors, anxiety (John Hopkins Medicine, 2022).

Hashimoto’s thyroiditis is estimated to have an incidence rate of 1.3% based on 5,000 children aged 11-18 years (Lee, 2022). According to Mincer and Jialal (2021), the incidence rate is estimated at 0.8 per 1000 per year in men and 3.5 per 1000 per year in women. Table 1 reflects these rates. In the Appalachian region, the incident rate of Hashimoto’s thyroiditis can be as high as 65 (Lee, 2022). The Colorado Thyroid Disease Prevalence Study included 25 862 adults (Lee, 2022). Of those adults, there was a 9.5% prevalence of elevated TSH in symptomatic and asymptomatic adults, with the higher percentage being women (Lee, 2022).

Surveillance and Reporting

 There is evidence to support annual surveillance. Initially, patients started on oral medications should be seen by their practitioner for 6-8 weeks (Lee, 2022). This visit will need to include laboratory studies to monitor the TSH level in the body (Lee, 2022). Patients receiving treatment without dosage adjustment for hypothyroidism should receive annual laboratory thyroid function testing (Mincer and Jialal, 2021). Hashimoto’s thyroiditis is a life-long disorder with no cure (Mincer and Jialal 2021). It can impact other laboratory studies. There is a need for evaluation of symptoms as well as laboratory studies to monitor for things such as anemia (Lee, 2022). There is no mandated reporting for Hashimoto’s thyroiditis.

Epidemiological Analysis

In the United States, Hashimoto’s thyroiditis is the most common cause of hypothyroidism (American Thyroid Association, 2022). There is a 10:1 ratio for female-to-male (Mincer and Jialal, 2021). Most diagnoses are between the ages of 30 and 50 (Mincer and Jialal, 2021). The peak age for men is approximately 10-15 years later than for women (Lee, 2022). Women are estimated to be 10-15 times more likely to develop Hashimoto thyroiditis than men (Lee, 2022). At the same time, no gene that carries Hashimoto’s thyroiditis has been found, but it does tend to run in families (John Hopkins Medicine, 2022). It is the most common cause of hypothyroidism in the United States (Mincer and Jialal, 2021).

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