DISORDERS
HYPERTHYROIDISM : excessive circulating HYPOTHYROIDISM :
Deficiency of
thyroid hormone .
thyroid hormone .
*
Hypermetabolic state # *
Hypo metabolic state #
'
RISK FACTORS . . .
-
RISK FACTORS . . .
Grave 's Disease :( toxic diffuse goiter)→
> >
More common in women than men
most common cause Female / 30 Uoylo are affected 7- 10x more
- -
-
>
Toxic Nodular Goiter : less common , than males .
Overproduction of TH due to
>
Inadequate intake of iodine
pretense of thyroid nodules .
>
Radiation therapy to head / neck
>
Exogenous Hyperthyroidism :(awed by "" " " " dosage
>
Meds : lithium + amiodarone
Of thyroid hormone .
-
EXPECTED FINDINGS . . .
•
EXPECTED FINDINGS . . .
>
Fatigue / lethargy / lot sleep / day )
>
Irritability
>
Heat intolerance
1011W / tnappetite
>
weight
>
cold intolerance
Insomnia / interrupted sleep weight gain w/ Orin caloric intake
> >
.
Tachycardia palpation tdysrnythmtas
>
Mental dullness
>
,
>
Thyroid Gland Produces .
fingernails thickening
.
of
.
Thick / brittle
>
>
Gravel Distaff / Goiter
1) Thyroxine 1-141 ,
>
tnsyltolil BP & widened DUIU pressure 2) Triiodotnyronineltz) skint hair 1015 .
*>
Thyroid 3) Tnyrocalcitonin
Myxedema
>
bruit
> :
regulated by : swelling of /kin /
>
-13+-14
Fatigue / menstrual irregularity
> '
Anterior Pituitary
LABORATORY TESTS facial swelling
'
. . .
>
-13514 affect All body systems
Blood TSH Level :(NO .4mU / L )
>
regulating metabolism
-
.
Decreased w/ Grave 's Disease
-
energy production , tissue uuof
Free -14 Index : increased talents w/ disease fats .pro/-einItcarbs
>
.
>
Radioactive Iodine uptake IRAIU) :
distinguishes Grave 's
-
LABORATORY TESTS . . .
disease from other forms of thyroiditis .
>
Blood Thyroid stimulating
-
Hormone 11TH ) :
'
NURSING CARE . . .
'
TIHTW / primary hypothyroidism
Ekofordysrnytnmias TSH WW / secondary hypothyroidism
>
monitor
'
ASAP /may Anti thyroid Antibodies : autoimmune origin
>
Report tempt of 1°F or more to provider
>
bests of impending thyroid crisis) .
>
-13+-14 : Decreased
>
Nutritional Therapy : high calorie diet /4,000 -5,000cal /day -
'
NURSING CARE . . .
bfultmeaslday Monitor cardiovascular changes :dBP bradycard
>
protein → I -291kg
-
,
,
Mart intake /trfiber.ca/feinet1easonedfOOds dysrhytnmias chest pain , peripheral edema
-
,
>
minimize clients energy expenditure Anti embolism stockings + elevation
> -
-
COMPLICATIONS . . .
>
DO NOT use electric blankets
>
Thyrotoxic crisis :
life-threatening condition .
-
COMPLICATIONS . . .
*>
'
severe tachycardia , heart failure , shock , Myxedema coma life-threatening condition
:
,
hyperthermia / 10601=1 , agitation , seizures ,
occurs when hypothyroidism is untreated po ,
delirium + coma .
Managed or stressor affects the client .
* Maintain a patent airway is PRIORITY # '
Resp failure hypotension
.
, , hypoglycemia , com
>
Hypocalcemia :
damage to parathyroid gland causes Impaired consciousness + subnormal temps
-
.
hypocalcemia t tetany Treatment → IV thyroid hormone
-
.
, -
MEDICATIONS . . .
'
MEDICATIONS . . .
Thionamides :[metnimazoletpropy / thiouracil ] Thyroid Hormone Replacement Therapy
> '
:
* inhibit production of thyroid hormone # * Levothyroxine : synthetic thyroid hormone
client Education :
replacement
'
.
Take wlmeal.in divided doses at regular Nursing Action :
>
-
intervals ( maintains even therapeutic effect) .
>
Fiber supplements, calcium , iron .
tantacid
>
report fever soar throat , , jaundice ,t bruins interfere w/ absorption
to provider
>
Monitor for cardiovascular compromise
>
Iodine intake Client Education :
•
monitor for manifestations of
>
>
hypothyroidism Treatment begins SLOWLY , increasing
Adrenergic :[propranolol
Blockers atenololt] 2-3 WKS
>
Beta -
, every .
metoprolol
* Treats tachycardia tpaipitationstx
>
Blood TSH is monitored
Client Education 30 -60min before breakfast
- >
: .
change positions slowly / med causes dizziness) Life-long treatment
> >
>
Take pulllblfeachdou.no/-ifyproVl-derif
>
Monitor / reports/Sof hyperthyroidism
HRW 601min .
Nursing Action :
'
Monitor BP, HRitECG
>
>
monitor for hypoglycemia
↳
( patient 's WI diabetes) nonradioactive
>
Iodine solutions :( ugois solution
-
/.gg?nYmenifiodinein101opotalIiUM
* short-term UU only # 40 days followed by surgery )
client Education :
•
>
Take iodine solution 1hr after thyroid meds
pregnant
>
DONOTUU While
juice iuseltrawtoavoid staining
>
Mix w/
teeth
HYPERTHYROIDISM : excessive circulating HYPOTHYROIDISM :
Deficiency of
thyroid hormone .
thyroid hormone .
*
Hypermetabolic state # *
Hypo metabolic state #
'
RISK FACTORS . . .
-
RISK FACTORS . . .
Grave 's Disease :( toxic diffuse goiter)→
> >
More common in women than men
most common cause Female / 30 Uoylo are affected 7- 10x more
- -
-
>
Toxic Nodular Goiter : less common , than males .
Overproduction of TH due to
>
Inadequate intake of iodine
pretense of thyroid nodules .
>
Radiation therapy to head / neck
>
Exogenous Hyperthyroidism :(awed by "" " " " dosage
>
Meds : lithium + amiodarone
Of thyroid hormone .
-
EXPECTED FINDINGS . . .
•
EXPECTED FINDINGS . . .
>
Fatigue / lethargy / lot sleep / day )
>
Irritability
>
Heat intolerance
1011W / tnappetite
>
weight
>
cold intolerance
Insomnia / interrupted sleep weight gain w/ Orin caloric intake
> >
.
Tachycardia palpation tdysrnythmtas
>
Mental dullness
>
,
>
Thyroid Gland Produces .
fingernails thickening
.
of
.
Thick / brittle
>
>
Gravel Distaff / Goiter
1) Thyroxine 1-141 ,
>
tnsyltolil BP & widened DUIU pressure 2) Triiodotnyronineltz) skint hair 1015 .
*>
Thyroid 3) Tnyrocalcitonin
Myxedema
>
bruit
> :
regulated by : swelling of /kin /
>
-13+-14
Fatigue / menstrual irregularity
> '
Anterior Pituitary
LABORATORY TESTS facial swelling
'
. . .
>
-13514 affect All body systems
Blood TSH Level :(NO .4mU / L )
>
regulating metabolism
-
.
Decreased w/ Grave 's Disease
-
energy production , tissue uuof
Free -14 Index : increased talents w/ disease fats .pro/-einItcarbs
>
.
>
Radioactive Iodine uptake IRAIU) :
distinguishes Grave 's
-
LABORATORY TESTS . . .
disease from other forms of thyroiditis .
>
Blood Thyroid stimulating
-
Hormone 11TH ) :
'
NURSING CARE . . .
'
TIHTW / primary hypothyroidism
Ekofordysrnytnmias TSH WW / secondary hypothyroidism
>
monitor
'
ASAP /may Anti thyroid Antibodies : autoimmune origin
>
Report tempt of 1°F or more to provider
>
bests of impending thyroid crisis) .
>
-13+-14 : Decreased
>
Nutritional Therapy : high calorie diet /4,000 -5,000cal /day -
'
NURSING CARE . . .
bfultmeaslday Monitor cardiovascular changes :dBP bradycard
>
protein → I -291kg
-
,
,
Mart intake /trfiber.ca/feinet1easonedfOOds dysrhytnmias chest pain , peripheral edema
-
,
>
minimize clients energy expenditure Anti embolism stockings + elevation
> -
-
COMPLICATIONS . . .
>
DO NOT use electric blankets
>
Thyrotoxic crisis :
life-threatening condition .
-
COMPLICATIONS . . .
*>
'
severe tachycardia , heart failure , shock , Myxedema coma life-threatening condition
:
,
hyperthermia / 10601=1 , agitation , seizures ,
occurs when hypothyroidism is untreated po ,
delirium + coma .
Managed or stressor affects the client .
* Maintain a patent airway is PRIORITY # '
Resp failure hypotension
.
, , hypoglycemia , com
>
Hypocalcemia :
damage to parathyroid gland causes Impaired consciousness + subnormal temps
-
.
hypocalcemia t tetany Treatment → IV thyroid hormone
-
.
, -
MEDICATIONS . . .
'
MEDICATIONS . . .
Thionamides :[metnimazoletpropy / thiouracil ] Thyroid Hormone Replacement Therapy
> '
:
* inhibit production of thyroid hormone # * Levothyroxine : synthetic thyroid hormone
client Education :
replacement
'
.
Take wlmeal.in divided doses at regular Nursing Action :
>
-
intervals ( maintains even therapeutic effect) .
>
Fiber supplements, calcium , iron .
tantacid
>
report fever soar throat , , jaundice ,t bruins interfere w/ absorption
to provider
>
Monitor for cardiovascular compromise
>
Iodine intake Client Education :
•
monitor for manifestations of
>
>
hypothyroidism Treatment begins SLOWLY , increasing
Adrenergic :[propranolol
Blockers atenololt] 2-3 WKS
>
Beta -
, every .
metoprolol
* Treats tachycardia tpaipitationstx
>
Blood TSH is monitored
Client Education 30 -60min before breakfast
- >
: .
change positions slowly / med causes dizziness) Life-long treatment
> >
>
Take pulllblfeachdou.no/-ifyproVl-derif
>
Monitor / reports/Sof hyperthyroidism
HRW 601min .
Nursing Action :
'
Monitor BP, HRitECG
>
>
monitor for hypoglycemia
↳
( patient 's WI diabetes) nonradioactive
>
Iodine solutions :( ugois solution
-
/.gg?nYmenifiodinein101opotalIiUM
* short-term UU only # 40 days followed by surgery )
client Education :
•
>
Take iodine solution 1hr after thyroid meds
pregnant
>
DONOTUU While
juice iuseltrawtoavoid staining
>
Mix w/
teeth
