Hypothyroidism
what is Hashimoto thyroiditis?
destructive autoimmune disorder in which infection and inflammation of the thyroid gland causes the production of
decreased metabolism, cold intolerance
what is Graves disease?
overactivity of thyroid, S/S= exophthalmos (budging eyes), heat intolerance, increased energy
Tx of hypothyroidism (med)
levothyroxine (lifelong tx)
S/S of Hypothyroidism?
Hypoventilation, SOB, bradycardia, dysrhythmias, HoTN, decreased activity intolerance, enlarged heart, Decreased metabolic rate, decreased cold tolerance, Anorexia, weight gain, constipation, abdominal distension, Depression, Pale, cool, yellow, dry, scaly skin, thick brittle nails, coarse, dry, brittle hair, decreased hair growth, poor wound healing , loss of eyebrow hair, Slowed thinking and speech, decreased attention span, decreased memory, difficulty, hearing, confused, lethargic, decreased DTRs, numbness/tingles of extremities, muscle aches and pains, Presence of a goiter
S/S of hyperthyroidism?
Increased BP, HR, blood flow, chest pain, rapid shallow respirations, Increased metabolic rate, heat intolerance, fever, fatigue, protein buildup (negative nitrogen balance), hyperglycemia, decreased body fat, increased intolerance Blurred double vision, tears, red eye fatigue, hyperactive DTRs, tremors, insomnia, diaphoresis, Silky soft body hair, warm moist skin, thinning of hair, Increased appetite, increased stools, weight loss, Amenorrhea, increased libido, Decreased attention span, restlessness, irritability, manic behavior, Bulging eyes (exophthalmos)
S/S of thyroid storm
hyperthermia, high fever, HTN, diarrhea, tremors, HF, delirium
What is myxedema?
severe hypothyroidism in adults, non pitting edema manifested in facial puffiness and a thick tongue
Post op monitor for
pain, hemorrhage, respiratory distress, tetany
Tx of thyroid storm
ABCs, oral antithyroid medications, propranolol IV, monitor for dysrhythmias, VS q30 mins
Primary hypothyroidism (patho and labs)
thyroid gland can't function, most common type
increased TSH, decreased T3 and T4
What should you never do to a goiter
palpate
Radiation precautions
Use separate toilet, sit to urinate, flush toilet three times with the lid closed after use, do not use absorbent gel-filler briefs, avoid contact with pregnant women, no saliva sharing, machine wash clothes only (separate and run washer empty after use), use a laxative on the second or third day
what is primary hypothyroidism (patho and labs)?
arises from pituitary gland, results from decreased production of TSH
decreased TSH, T3 and T4
Labs for graves disease
increased T3 and T4 and low TSH
Methimazole black box warning