Endocrine System - Thyroid Gland Disorders

Front 1

Hypothyroidism

Back 1

1. Results from hyposecretion of thyroid hormones T3 &T4
2. Characterized by a decreased rate of body metabolism

Front 2

Hypothyroidism
(Assessment)

Back 2

1. Lethargy and fatigue
2. Weakness, muscle aches, parethesias
3. Intolerance to cold
4. Weight gain
5. Dry skin and hair and loss of body hair
6. Bradycardia
7. Constipation
8. Generalized puffiness and edema around the eyes and face
9. Forgetfulness and loss of memory
10. Menstrual disturbances
11. Cardiac enlargement, tendency to develop congestive heart failure
12. Goiter may or may not be present

Front 3

Hypothyrodism
(Interventions)

Back 3

1. Monitor vital signs, including heart rate and rhythem
2. Administer thyroid replacement; levothyroxine sodium (Syngthroid) is most commonly prescribed
3. Instruct the pt in a low-calorie, low-cholesterol, low-saturated fat diet
4. Monitor for overdose signs
a. Tacycardia
b. Chest pain
c. Restlessness
d. Nervousness
e. Insomnia

Front 4

Myxedema Coma

Back 4

1. This rare but serious disorder results from persistently low thyroid production
2. Coma can be precipitated by acute illness, rapid withdrawal, of thyroid medication, anesthesia and surgery, hypothermia, or the use of sedatives and opiod analgesics

Front 5

Myxedema Coma
(Assessment)

Back 5

1. Hypotension
2. Hypothermia
3. Hyponatremia
4. Hypoglycemia
5. Bradycardia
6. Generalized edema
7. Respiratory failure
8. Coma

Front 6

Myxedema Coma - Interventions

Back 6

1. Administer
a. IV fluids (normal or hypertonic saline) as prescribed
b. Levothyroxine Na+ intravenously as prescribed
c. glucose IV as prescribed
d. Corticosteroids as prescribed
2. Monitor BP frequently
3. Monitor for changes in pt mental status
4. Monitor electrolyte & glucose levels
5. Keep pt warm

Front 7

Hyperthyroidism

Back 7

1. State resulting from hypersecretion of thyroid hormones (T3 &T4)
2. Characterized by an increased rate of body metabolism
3. A common cause of GRAVE'S DISEASE (aka = toxic diffuse goiter)
4. Clinical manifestations are referred to as thyrotoxicosis

Front 8

Assessment for Hyperthyrodism caused by Grave's Disease

Back 8

1. Enlarged thyroid gland (goiter)
2. Palpitations, cardiac dysrhythmias, such as tachycardia or atrial fibrillation
3. EXOPHTHALMOS (protruding eyeballs)
4. Hypertension
5. Heat intolerance
6. Diaphoresis
7. Wt. loss
8. Diarrhea
9. Smooth, soft skin and hair
10 Nervousness and fine tremors of the hands
11. Personality changes such as:
a. Irritability
b. Agitation
c. Mood swings

Front 9

Hyperthyroidism - Interventions

Back 9

1. Provide adequate rest
2. Administer sedatives as prescribed
3. Provide a cool and quiet environment
4. Obtain wt daily
5. Provide a HIGH CALORIE DIET
6. Avoid the administration of stimulants
7. Administer the following as prescribed:
a. Antithyroid medications that block thyroid synthesis
b. Iodine preparations that inhibit the release of thyroid hormone
c. Propranolol for tachycardia
8. Prepare pt for thyroidectomy

Front 10

Thyroid Storm

Back 10

1. An acute and life-threatening condition which occurs in a client with uncontrollable hyperthyroidism
2. It can be caused by manipulation of the thyroid gland during surgery and the release of thyroid hormone into the bloodstream.
a. It also can occur from severe infection and stress
3. Antithyroid medication, B-blockers, glucocorticoids, and iodines may be administered to the pt before thyroid surgery to prevent its occurance

Front 11

Assessment for Thyroid Storm

Back 11

1. Elevated temp (fever)
2. Tachycardia
3. Systolic hypertension
4. Nausea, vomiting & diarrhea
5. Agitation, tremors, anxiety
6. Irritability, agitation, restlessness, confusion and seizures as the condition progresses
7. Delirium and coma

Front 12

Thyroidectomy

Back 12

Performed when persistent HYPERTHYROIDISM exists

Front 13

Preoperative Interventions for Thyroidectomy

Back 13

1. Instruct the pt in how to perform coughing and deep-breathing exercises and how to support the neck in the postoperative period when coughing and moving.

Front 14

Postoperative Interventions for Thyroidectomy

Back 14

1. Monitor for respiratory distress
2. Have a tracheotomy set, oxygen, and suction at the bedside
3. Limit pt talking, and assess the level of hoarseness
4. Monitor for laryngeal nerve damage, as evidenced by respiratory obstruction, dysphonia, high-pitched voice, stridor, dyshagia, and restlessness
5. Monitor for hypocalcemia and tetany (calcium gluconate is given for tetany)