CRETINISM HORMONE AND MYXOEDEMA
CRETINISM
Congenital hypothyroidism which results in growth retardation ,development delay and other abnormalities .It can be due to defifirnccy of iodine in mothers diet during pregnancy and genetic enzyme defects.
treatment
Thyroid hormone replacement ,dietary iodide supplementation ,soy based formula and iron medication ,and increased activity.
MYXOEDEMA
Refers to a severe form of hyppthyrodism that can occur when the condition is is left untreated .It can also make the skin appear swollen and puffy.
assessment and common findings
-Insidious and slow onset ,loss of appetite while gaining weight due to slow metabolism rate.
-Sluggishing in both physical and mental activities.
-Cold intolerance ,disturbed memory ,fatigue and sleeping for long hours.
-Constipation ,flactulence ,and abdominal distension.
-Husky voice ,depression ,coarse skin and brittle hair and nails.
-Swollen face with eyelids.
-Enlarged thyroid gland.
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treatment
-Hormone replacement therapy using thyroxine.
-Gradually increase it.
-The nurse should educate the client about the importance of compliance with daily medication especially if its an older patient.
-The nurse should also teach the client about proper skin care, like applying lotions to prevent skin damage or dryness.
-Also educate the client about the importance of follow up in order to monitor if the treatment is working.
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treatment
assessment and common findings
risk factors of cretinism and myoxedema
-a person older than 60 years
-family history of the disease
-a person who has an auto immune disease
-a person who has received radiation
-a person who has had thyroid surgery
-other medications
-a person who has been pregnant or delivered a baby within the past 6 months
-low hairline ,dry brittle hair
-failure to thrive
-failure to suck when breastfeeding
-dull ,puffy face
large ,thick and protruding tongue
-excessive sleeping
-decreased activity
-chocking
-constipation
nursing management /care for cretinism and myxoedema**
promote rest-space activities to promote rest and exercise as tolerated
protect against coldness -provide extra blanket
avoid heat exposure -discourage and avoid the use of external heat source
mind the temperature -monitor the patients body temperature
increase fluid intake -encourage increased fluid intake within the limits of fluid restriction
manage respiratory symptoms -monitor respiratory depth ,rate ,pattern ,pulse oximetry and ABG
Pulmonary exercises-encourage deep breathing ,coughing and use of incentive spirometry