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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