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16 Cards in this Set

  • Front
  • Back
Results when the thyroid gland produces an insufficient amount of thyroid hormone .
• Everything SLOOOOWS Down!
– Metabolism rate decreases
– Heat production decreases
• May be primary or secondary
• Congenital hypothyroidism
– Results in mental and physical retardation
if not treated immediately
• Cretin: Normal developing infant with replacement therapy
– Primary: Most common, may be caused by congenital defects in gland, loss of thyroid tissue
following treatment of hyperthyroidism, antithyroid medications, thyroiditis, endemic iodine insufficiency
• Secondary:
• Secondary:
– Results from a pituitary TSH deficiency
– Peripheral resistance to thyroid hormones
• Slow onset, months to years
– With treatment mental and physical symptoms reverse in clients of all ages!
• Replacement of thyroid hormones may lead to hyperthyroidism – it is a balancing act!!
More common in
• More common in women, ages 30 to 60.
• Myxedema: characteristic accumulation of nonpitting edema in the connective tissues throughout the body. The edema is water retention in mucoprotein deposits in the interstitial spaces.
– Face is puffy
– Tongue is enlarged

As TH production decreases, the thyroid gland _______
• As TH production decreases, the thyroid gland
Enlarges in an attempt to produce more of the hormone.
• A goiter will typically form.
• A lack of iodine may precipitate hypothyroidism. Iodine is necessary for the synthesis and secretion of TH.

What does this disorder look like?
What does this disorder look like?
• Presence of the goiter
• Dyspnea
• Fluid retention and edema
• Decreased appetite
• Weight gain
• Constipation
• Dry Skin
• Muscle Stiffness
• Neurologic changes
• Anemias
• Cardiovascular Deficits (Increased risk for atherosclerosis)
• Iodine Deficiency
• Iodine Deficiency
– Certain goitrogenic drugs (block TH synthesis)
– Lithium carbonate (manic-depressive disorders)
– Antithyroid drugs
– Certain foods containing goitrogenic compounds:
• Turnips, rutabagas, soybeans
Hashimoto’s Thyroiditis
• Hashimoto’s Thyroiditis
– Most common cause of primary hypothyroidism
– Antibodies develop that destroy thyroid tissue
– Fibrous tissue develops, TH levels decrease
Myxedema coma, or hypothyroid crisis
Myxedema coma, or hypothyroid crisis
is a serious complication to prolonged hypothyroidism.
• Life-threatening:
– Severe metabolic disorders (hyponatremia, hypoglycemia, lactic acidosis
– Hypothermia
– Cardiovascular collapse
– Coma
• Life Threatening
• End stage of hypothyroidism. Usually occurs in older adults
• More prevalent in winter months /exposure to cold temperature
• Certain medications
• Mortality Rate: 50% Treat with 300-500 mcg IV of T4 , followed by 50-100 mcg IV daily until stable
• Maintaining a patent airway
• Maintaining fluid, electrolyte and acid-base balance
• Maintaining cardiovascular status
• Increasing body temperature
• Increasing TH levels
Lab and Diagnostics
Lab: TH, T4 tests
• Pharmacology: Drug therapies that replace TH.
• Surgery: If goiter is causing respiratory or dysphagia, a subtotal thyroidectomy may be performed
Synthroid / Levothroid
– Take drug for life
– Don’t switch to generic
– Take drug in a.m.
– Take drug 1 hr before or 2 hrs after a meal for best absorption
– Monitor for coronary insufficiency (chest pain, dyspnea, tachycardia

– Avoid excessive consumption of foods that inhibit TH utilization
– Potentiate effect of anticoagulant drugs and digitalis
– Insulin needs may need to be adjusted as thyroid function increases
Nursing Care for Clients with Hypothyroidism
• Decreased cardiac output
• Constipation
• Risk for Altered Skin Integrity
• Altered Thought Processes
• Risk for Altered Body Temperature
• Activity Intolerance
• Impaired Verbal Communication
• Self-Esteem Disturbance

Expected Outcomes:
Expected Outcomes:
Regain normal bowel elimination patterns, having a soft, formed stool at least every other day
Eat a diet high in fiber and in fluids
Experience improvement in verbal communication
Regain positive self-esteem as medications reduce physical changes and increase activity levels.
Nursing Interventions:
Nursing Interventions:
Thorough history,
Attention to change in activity, hair, skin, nail, chest pain, syncope, change in wt., bowel elimination
Skin texture, nonpitting edema, neck/hair - presence of goiter, body hair