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Hypothyroidism, Holman, H. C., Williams, D., Johnson, J., Ball, B. S.,…
Hypothyroidism
Interventions
monitor the patients vitals very closely in case cardiac or respiratory involvement.
Meds - synthetic hormone - levothyroxine sodium (synthroid)
Monitor the clients weight
provide good skin care
provide extra clothing and blankets
Monitor for any s/s of myxedema or myxedema coma
Patient Education
Don't switch thyroid hormone therapy brands, take in the morning before food
dont use electric blankets or other heating devices because it can result in unrecognized burns
Have a good exercise regimen as well as a healthy diet (low calorie, high bulk diet)
Drink plenty of water
report chest pain or discomfort immediately
take thyroid replacement as prescribed without changing anything unless physician is consulted
Pathophysiology
inadequate amount of thyroid hormones (T3 and T4), causing a decrease in metabolic rate that affects body systems
primary - dysfunction of thyroid gland, most common type and can be caused by disease (autoimmune thyroiditis), use of meds that decrease synthesis, or loss of thyroid gland
secondary - caused by failure of anterior pituitary gland to stimulate the thyroid gland or failure of target tissues to respond to thyroid hormones (pituitary tumors)
tertiary - caused by failure of hypothalamus to produce thyroid - releasing hormone
risk factors - females 30-60 years old, certain meds (lithium, amiodarone), inadequate intake of iodine, radiation therapy to head or neck
Assessment
manifestations - dry/coarse hair, bradycardia, cold intolerance, depression, anorexia, weight gain, constipation, slow speech, lethargy, confusion, goiter, myxedema, mxyedema coma
Labs - T3 and T4 decreased, blood thyroid stimulating hormone (TSH) increased with primary, blood cholesterol increased, antithyroid antibodies, present in some cases
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute
References
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing:
Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5