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40 Cards in this Set
- Front
- Back
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Hypothyroidism can occur?
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anytime throughout life
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Reasons that hypothyroidism may occur?
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*cells are damaged and no longer funtioning normally
*person doesn't ingest enough of substances needed to make thyroid hormones, esp. iodide and tyrosine |
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Myxedema can change client's appearance by?
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nonpitting edema forms everywhere, esp. around eyes, hands, feet, between shoulder blades...tongue thickens and edema forms in larynx, making voice husky
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What does myxedema coma cause?
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decreases metabolism causing heart muscle to become flabby and chamber size to increase...results in decreased cardiac output and decreased perfusion to brain and other vital organs...tissue and organ failure ensues...life-threatening
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Most cases of hypothyroidism occur as a result of?
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thyroid surgery and RAI treatment of hyperthyroidism
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Worldwide, hypothyroidism is caused by a lack of?
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iodide
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Hypothyroidism occurs most often in women between?
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30 and 60 years
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Women are more affected with hypothyroidism how many more times than men?
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7 to 10
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Hypothyroidism can increase sleep time sometimes up to?
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14 to 16 hours daily
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Symptoms of hypothyroidism?
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generalized weakness
anorexia muscle aches paresthesias constipation cold intolerance decrease in libido amenorrhea or heavy, prolonged bleeding difficulty becoming pregnant impotence and infertility |
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The following drugs can impair thyroid hormone production?
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lithium
aminoglutethimide perchlorate thiocyanates cobalt |
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Hypothyroid physical changes in appearance include?
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coarse features
edema around eyes and face blank expression thick tongue overall muscle movement slow |
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Hypothyroid psychosocial assessment?
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depression
lethargic apathetic drowsy withdrawn impaired attention span and memory |
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Laboratory assessment for hypothyroidism is opposite of HT?
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triiodothyronine (T3) down
thyroxine (T4) serum levels down TSH levels high in primary hypothyroidism, but down or near normal in secondary hypothyroidism |
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Nursing diagnosis:
Decreased cardiac output related to? |
altered heart rate and rhythm as a result of decreased myocardial metabolism
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Nursing diagnosis:
Ineffective breathing pattern related to? |
decreased energy, obesity, and fatigue
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Nursing diagnosis:
Disturbed thought processes related to? |
impaired brain metabolism and edema
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The major collaborative problem with hypothyroidism is?
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Potential for myxedema coma
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Nursing diagnosis:
Imbalanced nutrition: more than body requirements related to? |
excessive intake in relation to metabolic need
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Nursing diagnosis:
Hypothermia related to? |
decreased metabolic rate
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Nursing diagnosis:
Constipation related to? |
decreased motility of GI tract
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Nursing diagnosis:
Disturbed body image related to? |
illness
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Nursing diagnosis:
Deficient knowledge of condition, diagnosis, and treatment related to? |
cognitive limitation
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Nursing diagnosis:
Potential for paralytic ileus and potential for cardiomyopathy okay |
okay
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Expected outcomes for nursing diagnosis of Decreased Cardiac Output for client with hypothyroidism is?
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maintains heart rate above
60 beats/min maintains blood pressure within normal limits for his or her age and general health has no dysrhythmias, peripheral edema, or neck vein distention |
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Interventions for nursing diagnosis of Decreased Cardiac Output for client with hypothyroidism?
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Monitor blood pressure, heart rate, and rhythm and observe closely for signs of shock, such as hypotension, decreasing urine output, and changes in mental status..
Instruct client to report episodes of CHEST PAIN or DISCOMFORT IMMEDIATELY!! requires lifelong thyroid hormone replacement ex: levothyroxine in the form of Synthroid, T4, or Eltroxin start low doses and gradually increase over a period of weeks..the more severe cases of hypothyroidism start on lowest dose..too high dose or increasing dose too rapidly can cause severe hypertension, heart failure, myocardial infarction assess for chest pain and dypnea during start of therapy...HYPERthyroidism may be a condition of replacement therapy |
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Hypothyroidism
Expected Outcomes for nursing diagnosis of Ineffective Breathing Pattern? |
may have mildly compromised respiratory function...indicators include:
maintenance of SpO2 of at least 88% absence of cyanosis maintenance of cognitive orientation |
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Hypothyroidism
Interventions for nursing diagnosis of Ineffective Breathing Pattern? |
record respirations
auscultate for decreased breath sounds ventilatory support may be required (since there are respiratory difficulties associated with hypothyroidism, be sure and give LOW doses of SEDATIVES, because patient is more sensitive) |
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Severe respiratory distress often occurs with?
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myxedema coma
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Hypothyroidism
Expected outcomes for nursing diagnosis of Disturbed Thought Processes? |
thought process disturbance
may be mild...assess to see that patient: demonstrates immediate memory communicates clearly and appropriately for age and ability is attentive during conversations |
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Hypothyroidism
Interventions for nursing diagnosis of Disturbed Throught Processes? |
record presence and severity
of: lethargy drowsiness memory deficit poor attention span difficulty communicating takes about 2 weeks for medication to kick in..so use LOC and explain all procedures slowly and carefully..provide safe environment |
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Problems that occur with myxedema coma include?
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coma
respiratory failure hypotension hyponatremia hypothermia hypoglycemia |
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Untreated myxedema coma leads to?
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shock
organ damage death (check MENTAL STATUS every shift...DON'T wait for lab confirmation to treat!) |
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Hypothyroidism is usually a chronic condition? T or F
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true
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Home care management of hypothyroid patient includes?
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one-floor living due to
fatigue extra heat or clothing due to cold intolerance help with drug regimen due to decreased attention span |
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The most important educational need for hypothyroid patient is?
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hormone replacement therapy
and its side effects Others: lifelong drugs mandatory medical alert bracelet dosage adjustment may be necessary over time NO OTC DRUGS adequate fiber and fluid intake to prevent constipation...fiber supplements may interfere with thyroid replacement hormone absorption adequate rest family needs to understand it takes time for med to work and they should expect mental dullness or slowness for some time.. speak clearly and slowly to patient |
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Name 9 conditions or events precipitating myxedema?
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acute illness
anesthesia chemotherapy hypothermia inadequately treated hypothyroidism rapid withdrawal of thyroid medications sedatives/opioids surgery untreated hypothyroidism |
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Causes of hypothyroidism are classified by?
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primary causes
decreased thyroid tissue decreased synthesis of thyroid hormone secondary causes inadequate production of thyroid-stimulating hormone |
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Primary causes of hypothyroidism include?
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Decreased Thyroid Tissue
surgical removal of thyroid radiation-induced thyroid destruction autoimmune thyroid destruction congenital thyroid agenesis congenital thyroid hypoplasia congenital thyroid dysgenesis cancer (thyroidal or metastatic) Decreased Synthesis of Thyroid Hormone: endemic iodine deficiency excessive exposure to iodine medications including: lithium phenylbutazone propylthiouracil sodium or potassium perchlorate aminoglutethimide |
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Secondary causes of hypothyroidism include?
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Inadequate Production of Thyroid-Stimulating Hormone:
pituitary tumors, trauma, infections, or infarcts congenital pituitary defects hypothalamic tumors, trauma, infections, or infarcts |
