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1. Signs and Hypothyroidism:
symp-toms of
hypothy-roidism Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought
and hy- process, Weight gain (5-10 lbs./2.25-4.5 kg) Constipation, Menorrhagia,
perthyroidism Cold intolerance: Cold all the time
Hyperthyroidism (aka graves disease):
Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg)
Diarrhea, loose, frequent stools, Oligomenorrhea, Heat intolerance: Hot
all the time
2. What
adjunctive
therapy is pg. 418-419
good to
prescribe to β-Blockers and nonradioactive iodine may be used as adjunctive therapy.
control symp- β-Block-ers suppress tachycardia by blocking β-receptors on the heart.
toms of hyper-
thyroidism oth- Nonradioactive iodine inhibits synthesis and release of thyroid
er than thyroid hormones.
specific pg. 419
medica-tions?
Know drug class-
es and
examples of
those drug
classes.
3. Monitoring
needs and
intervals
for thyroid
medications
.
levothyroxine-Monitoring: Check TSH 6-8 weeks after initiating therapy and
after any dosage change. Check TSH at least once a year after serum TSH
is stabilized.
Methimazole-Monitoring: Check CBC with ditterential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver
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dysfunction.
Propylthiouracil (PTU)-
Treatment continues for 1-2
years
PTU has caused rare cases
of liver injury. Onset is
sudden and progression is
rapid.
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4. -
Propylthiouracil Treatment continues for 1-2 years
(PTU) carries a PTU has caused rare cases of liver injury. Onset is sudden and
risk for liv- progression is rapid. pg 421
er toxicity. Al-
though rare,
the FDA
recom-mends
against using
PTU as
a first-line treat-
ment due to po-
tential for
hepatic toxicity.
5. - Effects of ma-
ternal hypothy-
roidism on off-
spring and ap- Maternal hypothyroidism can result in permanent neuropsychological
propriate deficits in the child.
patient
teaching can decrease IQ and other aspects of neuropsychological function in the
related to need child.
for treat-ment.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism must
be diag-nosed and treated very early.
some authorities currently recommend routine screening for
hypothyroidism as soon as pregnancy is confirmed. If hypothyroidism is
diagnosed, replacement therapy should begin immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
When women taking thyroid supplements become pregnant, dosage
require-ments usually increase—often by as much as 50%. The need
for increased dosage begins between weeks 4 and 8 of gestation, levels
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ott at approximately week
16, and then remains
steady until parturition.
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