Endocrine Flashcards
Reduce or absent hormone secretion from the thyroid gland.
Hypothyroidism
• Primary (autoimmune, cancer, congenital, surgical/radiation induced)
• Secondary (medications, hyperthyroid treatment, tumors, trauma, infections)
• Women
• Ages 30-60 years
Causes Hypothyroidism
Medical Interventions: Fix Slowly
• Levothyroxine: Take on an empty stomach (helps absorption). Take early in the morning. Start on Medication slowly.
▪ Side effects- Tachycardia, heart palpitations.
• Oxygen
• IV Fluids (Caution/Can cause fluid overload)
• Rewarming (Patient is Cold)- Use REGULAR blanket, put clothes on.
Clinical Manifestations Hypothyroidism
Medical Interventions: Fix Slowly
• Maintain patent airway and ventilation.
• Assess vital signs.
• Heating measures (be careful not to warm up Pt too fast).
• Orient as needed (May have decreased LOC).
• Nutrition (High fiber diet- Whole wheat green leafy veggies/High protein).
• Mobility (ambulate Pt down hallway/not too intense of mobility).
Nursing interventions Hypothyroidism
Myxedema Coma (Hypothyroidism Crisis):
• Cause: Untreated or poorly treated hypothyroidism that is a life threatening emergency.
• Causes- Acute illness, Surgery, Discontinuation of thyroid replacement therapy, medications.
• Clinical Manifestations- Respiratory failure (Low RR), Severe hypotension, hypothermia, hypoglycemia, hyponatremia.
Hypothyroidism Complications:
• IV Levothyroxine
• IV Glucose
• Hypertonic IV Fluid.
• Maintain patent Airway.
• Check Temperature Constantly/hourly.
• Check BP Regularly/Hourly
• Monitor for changes in Mental Status.
treatment hypothyroidism
Excessive thyroid hormone secretion from the thyroid gland.
Hyperthyroidism
Graves Disease (Exophthalmos/abnormal protrusion of the eyes/complain of dry eyes), Excessive use of thyroid replacement therapy, Palpitation of Goiter (NEVER PALPATE).
Risk Factors Hyperthyroidism
• Metabolic- Increased metabolic rate, HEAT INTOLERANCE, Low-grade fever, fatigue.
• Gastrointestinal- Weight loss, Increased appetite, Diarrhea.
• Skin/Hair/Nails- Diaphoresis, Fine-Soft-Silky body hair, Thinning of scalp hair.
• Cardiopulmonary- Palpitations, hypertension, Tachycardia, Dysrhythmias, Chest pain,
• Neurological- Diplopia, increased tears hyperactive reflexes, tremors, insomnia,
• Other issues- Goiter, Manic behavior, Increased libido
Clinical Manifestations Hyperthyroidism
Medications:
• Propylthiouracil (PTU)- Block hormones going to thyroid. S&S- Liver toxicity (Jaundice), random itching, DARK urine.
• Methimazole
Hyperthyroidism Medical Interventions:
Medications:
▪ Toileting- Don’t share toilet with anybody (Due to Radioactive Urine). Men sit down to pee. Close toilet lid and flush 3 times.
▪ Bodily Fluids- Use biohazard bag. Don’t share toothbrush (Don’t share anything with body fluid). Use disposable.
▪ Laxative Use- Use laxative on 2nd or 3rd day to relieve constipation (caused by iodine).
▪ Clothing- Washing clothes (Can wash clothes in the same washing machine/not at the same time as someone else)
▪ Social Gatherings- Avoid social gatherings (due to comprised immune system and radiation). Cannot stand within 3 feet for over an hour.
▪ Diet- Monitor how much Iodine in foods. Shellfish, salt with Iodine, Dairy (milk, eggs, cheese, butter). DO NOT INGEST SEAFOOD (Shellfish).
Radioactive iodine Education
Done when medications have not helped
Thyroidectomy
Preoperative- Iodine treatment, Treat underlying symptoms.
• Postoperative: Monitor Vitals closely, use pillows for support (Semi-fowlers/Do Not HYPERFLEX), Monitor for parathyroid gland injury (TETANY due to hypocalcemia/Chvostek, Trousseau), Monitor for hemorrhage (Monitor vital signs/Excessive swallowing)**, Monitor for thyroid storm.
Thyroidectomy
• Monitor Vital signs closely.
• Reducing Stimulation.
• Cooling interventions.
• Artificial Tears.
Nursing interventions thyroidectomy
Uncontrolled hyperthyroidism
• Surgery
• Trauma
• Infection
• Diabetic ketoacidosis
• Palpation of the goiter
Thyroid Storm (Hyperthyroidism Complication):
Causes:
• High fever
• Sever hypertension
• Tachycardia
clinical manifestations thyroid storm
• Patent airway and adequate ventilation.
• Block Production: give antithyroid drugs (PTU).
• Block release: administer sodium iodine IV (after antithyroid.
Thyroid storm treatment
