Download Thyroid Disorders

Thyroid
Disorders
NUR 171
Disorders of Thyroid Gland
Fig. 50-5. Continuum of thyroid dysfunction.
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
Elsevier Inc.
Hyperthyroidism
Nursing and Collaborative Care
Hyperthyroidism
 Collaborative
Care
 Radioactive
iodine therapy
 Anti-thyroid drugs
 Iodine
 Β-adrenergic blockers
 Surgical therapy
 Nutritional therapy
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
Elsevier Inc.
Collaborative Care
 Radioactive

Treatment of choice in non- pregnant
adults
 Damages

or destroys thyroid tissue
Delayed response


iodine therapy (RAI)
2 to 3 months
Treated with anti-thyroid drugs and Inderal
before and during first 3 months of RAI
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
Elsevier Inc.
Collaborative Care
 PTU:
propylthiouracil, methimazole
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
Elsevier Inc.
Collaborative Care
 Subtotal

thyroidectomy
Indications
 Unresponsive
to drug therapy
 Large goiters causing tracheal compression
 Possible malignancy
 Individual not a good candidate for RAI
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
Elsevier Inc.
Hypothyroid
Types & Symptoms
Myxedema: Complication of
Hypothyrodism
Fig. 50-10. Common features of myxedema. Dull, puffy skin; coarse, sparse hair;
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of
periorbital edema; and prominent tongue.
Elsevier Inc.
Collaborative Care

Levothyroxine (Synthroid)


liothyronine (Cytomel)





Synthetic thyroid hormone T4
Synthetic thyroid hormone T3
Must take regularly
Monitor for angina and cardiac dysrhythmias.
Monitor thyroid hormone levels, and adjust (as
needed).
Liotrix (Thyrolar)
Copyright © 2011, 2007 by Mosby, Inc., an
affiliate of Elsevier Inc.
Copyright © 2014 by
Mosby, an imprint of
Elsevier Inc.
A patient has been taking levothyroxine for 6
months. After this month’s laboratory work, the
nurse practitioner tells the nurse that the patient is
“euthyroid.” What does that term mean?
A. The patient is experiencing hyperthyroidism.
B. The patient is experiencing hypothyroidism.
C. The patient’s thyroid hormone levels are within
normal limits.
D. The patient’s thyroid hormone levels are still
fluctuating.
11
Copyright © 2014 by
Mosby, an imprint of
Elsevier Inc.
A patient who is taking a thyroid
replacement medication tells the nurse
that she is starting to experience cold
intolerance, depression, constipation,
and dry skin. The nurse anticipates that
these manifestations are caused by
A.
B.
C.
D.
inadequate doses of the medication.
possible overdose of the medication.
worsening of the underlying disease.
drug interactions with another
medication.
12
Copyright © 2014 by
Mosby, an imprint of
Elsevier Inc.
Which information will the nurse include
when teaching a patient about thyroid
replacement therapy?
A. “Take the medication before bed.”
B. “You will experience beneficial effects of
the drug after one week of treatment.”
C. “Stop taking the drug if you experience
insomnia.”
D. “Take the medication on an empty
stomach.”
13
Copyright © 2014 by
Mosby, an imprint of
Elsevier Inc.
Which would be the best menu choice
for a patient who is taking an antithyroid
medication?
A.
B.
C.
D.
A seafood platter
Sushi
Tofu burger
Pasta with marinara sauce
14