Thyroid Glands

patho of thyroid gland

produces thyroid homones which regulates various functions in the body

what organs does the thyroid gland target

all organs

hypothyroidism

reduced or absent homone secretion from the thyroid gland

causes of hypothyroidism

women of child bearing age (30-60 years), autoimmune diseases, surgical or radiation induced, malignancies, infection, trauma

explanation of hypothyroidism s/s

low and slow

neurological s/s of hypothyroid

depression, slow slurred speech, paranoia

oxygenation s/s of hypothyroid

hypoventilation, dyspnea, pleural effusions

skin and hair s/s of hypothyroid

cold intolerance, poor wound healing, decreased hair growth

cardiovascular s/s of hypothyroid

bradycardia, dysrhythmias, hypotension

musculoskeletal s/s of hypothyroid

muscle weakness, fatigue, joint and muscle pain

GI s/s of hypothyroid

anorexia, cosntipation, weight gain

other s/s of hypothyroid

goiter, anemia, reproductive issues, oliguria

medication for hypothyroidism

levothyroxine

mechanism of action for levothyroxine

give very early in the morning on an empty stomach, start on a low dose

levothyroxine

replacement hormone

when should symptoms of hypothyroid resovle

once maintenance dose is achieved

when should you take levothyroxine

4 hours before or after meals

contraindications of levothyroxine

insulin or history of hypoglycemia

side effects of levothyroxine

heart palpitations, tachycardia, both are common

medical interventions for hypothyroid

oxygen therapy as needed, IV fluids, nutrition

what diet should people with hypothryoidism have

high fiber, smaller meals or snacks throughout the day, whatever their perferences are

how to encourage pt with hypothyroidism to eat

make them eat with a group

nursing interventions for hypothyroid

maintain patent airway, vitals, heating measures, orientation, mobility

what are the heating measures for hypothyroid

use extra blankets and put on extra layers of clothing

why should you not use warm blankets or heating pads for patients with hypothyroidism

increase risk of going into shock

mobility for hypothyroid

do not increase activity, let them rest, let them do what they can tolerate

hypothyroid complications

myxedema coma

s/s of myxedema coma

respiratory failure, severe hypotension, hypothermia, hypoglycemia, hyponatremia

management of care for myxedema

IV levothyroxine, IV glucose, IV fluids, airway, raise temperature, monitor vital signs, orient

how to maintain airway on pt with myxedema

suction, intubate pt in the ICU

hyperthyroidism

excessive thyroid hormone secretion for the thyroid gland

causes of hyperthyroidism

stress, graves disease, exccessive thyroid replacement, goiter palpitation

if patients have a goiter what should you do with your assessments

do not touch the lump on their neck

risks for hyperthyroidism

women, 20-40 years old

something to remember hyperthyroidism s/s

high and fast

nuerological s/s of hyperthyroidism

diplopia, hyperactive reflexes, tremors, insomnia

oxygenation s/s of hyperthyroidism

hyperventilation, tachypnea

skin and hair s/s of hyperthyroidism

heat intolerance, diaphoresis, thinning of scalp and hair

cardiovascular s/s of hyperthyroidism

palpitations, HTN, tachycardia, chest pain, dysrhthmias

musculoskeletal s/s of hyperthyroidism

muscle weakness and fatigue

GI s/s of hyperthyroidism

weight loss, increased appetite, diarrhea

other s/s of hyperthyroid

goiter, manic behavior, increase libido

hyperthyroidism medications

propylthiouracile (PTU) and methimazole, radioactive iodine

how long does it take for hyperthyroid medications to work

2 weeks

propylthiouracile and methimazole

blocks hormone release

side effects of propylthiouracile

hepatotoxicity, decrease immunity

hypertyroidism surgery

thyroidectomy

nursing intervention for hyperthyroidism

vital signs, reduce stimulation, cooling measures, artificial tears

what should the vitals be when treating hyperthyroidism

go down and does not continuously go up

how to reduce stimulation for hyperthyroidism patients

cold, low stimuli room
away from the nurses station

cooling measures for someone with hyperthyroidism

apply ice packs on core areas
give fresh, ice water regularly

artificial tears for hyperthyroid patients

moistens the eyes, use eye patches and alternate between the two

radioactive iodine

not really iodine; stops the secretion of t3 and t4 in the body

thyroidectomy

removal of the thyroid gland

what can also be removed during thyroidectomy

parts of the parathyroid glands; might be on calcium replacements

pre op thyroidectomy

take a small amount of radioactive iodine to decrease size of thyroid if too big

fix the signs and symptoms before going into surgery

what if the size of thyroid is not decreased before surgery

leads to bleeding

post op for thyroidectomy

monitor vitals, administer levothyroxine, position, assess dressing

how should you position a patient after thyroidectomy

position head in neutral position, in semi fowlers, to avoid putting pressure on the neck

hemorrhage signs for thyroidectomy

BP low and HR high, assess the throat, bandage is not saturated

what assessment findings should you see on thyroidectomy post op pt

bulging, discoloration in the back, how frequent they swallow

what does it mean if post op thyroidectomy pt is swallowing a lot

swallowing blood

hyperthyroidism complication

thyroid storm

s/s of thyroid storm

extremely high temperature, severe HTN, severe tachycardia

management of care for patient with thyroid storm

patent airway and adequate ventilation, medications, cardiac monitoring, cooling measures

medications for thyroid storm

IV antithyroid (ptu), IV sodium iodine, IV beta blocker, corticosteriods