Hypothyroidism

Question 1

Causes of hypothyroidism

Answer 1

Surgical removal of thyroid 
Anti thyroid drugs 
Lithium 
Inadequate ingestion of thyroid hormone
Amiodarone
Decreased secretion of thyroid hormone
Insufficient stimulation of TSH

Question 2

Diagnostic tests of hypothyroidism

Answer 2

Serum thyroid levels, TSH

Question 3

Treatments

Answer 3

Levothyroxine
Liothyronine
Liotrix

Question 4

Levothyroxine

Answer 4

Increases metabolic rate of protein, fat and carbs
Increase HR, RR, BP
Adverse effects: mimic hyperthyroidism, use in caution with older adults
Monitor for signs of bleeding, hyperglycemia
Can cause insomnia if taken at night

Question 5

Nursing care

Answer 5

H and P
VS 
CV, neuro pulmonary status, renal function, nutritional status lab values
Weight 
Monitor for signs of bleeding, hyperglycemia 
Assist with ambulation and ADLs 
Bleeding risks
Respiratory distress
Monitor Ca

Question 6

Patient education

Answer 6

Teach thyroid replacement is lifetime treatment
Take Levothyroxine in the morning and on empty stomach
take iron or Calicut supplements 4 hours after Levothyroxine
Change positions slowly
Notify dr if palpitations, sweating, irregular heart rate, nervousness, diarrhea
Don’t abruptly stop

Question 7

Risk factors for hypothyroid

Answer 7

Thyroid surgery 
Radiation
Anti thyroid meds
Goiter 
Hashimoto syndrome

Question 8

Manifestations of hypothyroidism

Answer 8

Decrease metabolic rate (everything slows down)
Lethargic, apathetic, weight gain
Cold, fatigue, menstrual problems, brittle nails, hair loss, thin skin
Enlaregement of gland,
Myxedema non pitting edema around eyes hands scapulae and feet
Enlarged tongue
Hoarse voice