Download Hypothyroidism is thyroid hormone deficiency. It can be due to

Hypothyroidism
What: The thyroid gland
helps to maintain a healthy
metabolism by producing and
releasing iodine-containing
hormones called thyroxine
(T4) and triiodothyronine
(T3). They help regulate the
body's growth, metabolism,
digestion, body temperature
and heartbeat. When the
thyroid gland produces a
deficient amount of
hormones it results in
hypothyroidism.
Occurrence: Hypothyroidism
is one of the most common
chronic disorders in the
United States. Roughly 11
million American adults and
children have this illness.
Etiology/Pathophysiology:
Hypothyroidism is thyroid
hormone deficiency. It can
be due to primary disease of
the thyroid gland itself or to
the lack of stimulation of the
thyroid gland by the pituitary
gland via the hormone TSH
(thyroid-stimulating
hormone).
References
Crawford, A., & Harris, H. (n.d.).
Thyroid imbalances: Dealing
with disorderly conduct.
(2012). 45-50. doi:
10.1097/01.NURSE.0000421372.
90370.3e
Ladwig, G., & Ackley, B. (2011).
Mosbey’s guide to nursing
diagnosis. (3 ed.). Maryland
Heights, MS: Mosby Elsevier.
Pearson, T. (n.d.). Hypothyroidism:
Challenges when treating older
adults. (2012). Journal of
Gerontological Nursing, 39(1),
10-14. doi: 10.3928/0098913420121204-02
Tabloski, P. (2011). Nclex review
questions. Retrieved from
http://wps.prenhall.com/chet_
tabloski_gerontolog_1/40/1030
5/2638128.cw/index.html
Unbound Medicine (2012) Nursing
Central [Mobile Application
Software] Retrieved from
http://itunes.apple.com/
Kylie Muntz
Ferris State University
Nursing 300
Clinical Manifestations: Clinical
manifestations of hypothyroidism are
caused by the decreased metabolic
rate.
 Constipation
 Fatigue
 Hypotension
 Shortness of breath
 Weight gain
 Cold intolerance
 Hair loss
 Aches
 Stiffness
 Decreased libido
 Slow tendon reflux
 Dry/thick tongue
 Edema around eyes
 Drooping eyelids
Potential Complications:
These complications occur if symptoms
are not treated.
 Cretinism
 Myxedema coma
 Goiter








Heart disease
CHF
intestinal obstruction
anemia
deafness
psychiatric problems
carpel tunnel
impaired fertility
Life Span/ Cultural Considerations
Hypothyroidism is more prevalent in the
Caucasian population than any other. It is
more prevalent in women. Women between
the ages of 30-60 are at highest risk. In
fact, about 10% of older women are
affected by hypothyroidism.
Causes

Autoimmune- (occurs when your own
bodies immune system develops
antibodies against your thyroid glands;
Graves Disease, Hashimoto’s Disease)


Surgical removal- due to tumor/cancer

Medicines- contribute to hypothyroidism;
such as lithium


Increase/Decrease in Iodine

(99% of all diagnosed cases are caused by an
autoimmune disease, or iatrogenic destruction of the
thyroid)
Congenital (occurs in 1/5,000 births)
preventable with neonatal screening and
treatment
1.
2.
Damage to Pituitary- the pituitary gland
is what stimulates your thyroid gland to
produce hormones
3.
Treatment- Hypothyroidism is a chronic disease.
Although it is not curable it is managed with
thyroid replacement supplements.
Nursing Diagnosis
1. Activity intolerance related to weakness
and apathy
*Outcome- The patient will demonstrate
increased tolerance to activity.
2. Constipation related to decreased gastric
motility.
*Outcome-The patient will maintain
passage of soft, formed stool every 1 to 3
days without straining.
3. Imbalanced Nutrition: more than body
requirements: related to decreased
metabolic process.
*Outcome- The patient will design dietary
modifications to meet individual long term
goals of weight control.
Other healthcare providers include:
1.
Physician- Gives the diagnosis and orders
for treatment
2.
Endocrinologist- Is needed for potential
endocrine/hormonal complications that
might arise.
3.
Social Workers- Provides support for the
patients and family if needed
4.
NCLEX Questions:
Which of the following conditions
is a subtle sign of hypothyroidism?
a. Diarrhea
b. Lethargy
c. Severe jaundice
d. Tachycardia
Causes of primary hypothyroidism
in adults include
a. malignant or benign thyroid
nodules
b. surgical removal or failure of
the pituitary gland
c. surgical removal or radiation of
thyroid gland
d. autoimmune-induced atrophy
of the gland
The nurse is caring for a patient
with a diagnosis of hypothyroidism.
Which nursing diagnosis should the
nurse most seriously consider when
analyzing the needs of the patient?
a. High risk for aspiration related
to severe vomiting
b. Hypothermia related to slow
metabolic rate
c. Diarrhea related to increased
peristalsis
d. Oral mucus membrane,
altered related to disease
process
A nursing student is studying for a
test on care of a client with
endocrine disorders. Which
statement demonstrates and
understanding of difference
between hypothyroidism and
hyperthyroidism?
a. Deficient amounts of TH cause
abnormalties in lipid
metabolism
b. Graves disease is most
common cause of
hypothyroidism
c. Decreased renal flow and
glomerular filtration rate
reduce the kidneys ability to
excrete water