Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
16 Cards in this Set
- Front
- Back
|
Hypothyroidism
|
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 |
|
|
Hypothyroidism
Cretinism |
• Congenital hypothyroidism
– Results in mental and physical retardation if not treated immediately • Cretin: Normal developing infant with replacement therapy |
|
|
Hypothyroidism
primary |
– 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 |
|
|
Hypothyroidism
• 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!! |
|
|
Hypothyroidism
More common in Myxedema:describe |
• 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 |
|
|
Hypothyroidism
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. |
|
|
Hypothyroidism
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) |
|
|
Hypothyroidism
• 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 |
|
|
Hypothyroidism
Hashimoto’s Thyroiditis |
• Hashimoto’s Thyroiditis
– Most common cause of primary hypothyroidism – Antibodies develop that destroy thyroid tissue – Fibrous tissue develops, TH levels decrease |
|
|
Hypothyroidism
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 |
|
|
Hypothyroidism
Treatment |
Hypothyroidism
Treatment • Maintaining a patent airway • Maintaining fluid, electrolyte and acid-base balance • Maintaining cardiovascular status • Increasing body temperature • Increasing TH levels |
|
|
Hypothyroidism
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 |
|
|
Hypothyroidism
Pharmacology 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 |
|
|
Hypothyroidism
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. |
|
|
Hypothyroidism
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 |
