Escolar Documentos
Profissional Documentos
Cultura Documentos
Part 1
Description: Thyroid
Butterfly shaped
Two lobes
connected by an
isthmus
Straddles the
trachea
Largest endocrine
gland
Function: Thyroid
1. Produce thyroid
hormones (TH)
Vital for growth
& metabolism
2. Iodine storage
Essential for
T3/T4 syntheses
Hormones
Hormone Function Stimulated by
Neurological
Heat intolerance
Diaphoresis
sympathetic
nervous response
Hyperthyroidism
S&S
Affect
Nervous
Emotional lability
Irritable
I Concentration
Mood swings
manic/psychotic
Hyperthyroidism
S&S
Cardiovascular
Tachycardia
Palpitations
Hyperthyroidism
S&S
Gastrointestinal
Appetite
Weight
BM
Diarrhea
Hyperthyroidism
S&S
Muscle-skeletal
Tremors
Restlessness
Muscle
weakness
Hyperthyroidism
S&S
Skin
Temperature
Warm
Smooth
Hair
Fine, soft
Gray
Loss
Hyperthyroidism
S&S
Exophthalmos
Bulging of the eye
Stare
Hyperthyroidism
S&S
Goiter
Enlarged thyroid
TSH levels
Hyperthyroidism
S&S
Oncholysis
Distal nail
separates from
the nail bed
Nail fragile
Hyperthyroidism
S&S
Gynecomastia
Abnormal
enlargement
breasts
male
Hyperthyroidism
S&S
Elderly
Heart failure
Fatigue
Apathy
Depression
Hormone Review
T3/T4
Pituitary
TSH
Thyroid
T3/T4
___________________
T3/T4
Pituitary
TSH
Thyroid
T3/T4
Hyperthyroidism
Diagnostic Tests
By definition hyperthyroidism
means what?
T3/T4
Primary Secondary
Hyperthyroidism Hyperthyroidism
T3/T4
TSH
Hyperthyroidism
Diagnostic Tests
By definition primary hyperthyroidism
means what? (where is the problem what
is causing the problem?)
Thyroid
T3/T4
In primary hyperthyroidism, is the pituitary
gland working correctly?
Yes
Hyperthyroidism
Diagnostic Tests
If the pituitary gland is working
correctly and there is an T3/T4
level, what will the Pituitary gland
do with the TSH level?
Primary Secondary
Hyperthyroidism Hyperthyroidism
T3/T4
TSH
Hyperthyroidism
Diagnostic Tests
By definition hyperthyroidism
means what?
T3/T4
Primary Secondary
Hyperthyroidism Hyperthyroidism
T3/T4
TSH
Hyperthyroidism
Diagnostic Tests
By definition secondary hyperthyroidism
means what? (where is the problem what
is causing the problem?)
Pituitary gland
TSH
T3/T4
Hyperthyroidism
Diagnostic Tests
Meds first
Goal
T3/T4 levels
Meds alone
sometimes work -
if not
Surgery
Hyperthyroidism
Medical Treatment
Anti-thyroid therapy
Propylthioracil /
PTU
Methimazole /
Tapazole
Action
Inhibits synthesis
of T3/T4
Hyperthyroidism
Medical Treatment
Propranolol
hydrochloride / Inderal
Beta-blocker
sympathetic nervous
system
No smoking
Hyperthyroidism
Medical Treatment
Iodine before
surgery
Potassium iodine
saturated
solution (SSKI)
vascularity of
the thyroid
risk of post-op
bleeding
Hyperthyroidism
Medical Treatment
Radioactive Iodine
I131
Used instead of
radiation tx
Stop anti-thyroid
meds x 7 days
Single dose
S&S in @ 3wks
full effect in 3
months
Hyperthyroidism
Medical Treatment
Radioactive Iodine
Safety
No PG nurses
Watch body fluids
Avoid kids x 7
days
Hyperthyroidism
Medical Treatment
Diet (When hyperthyroid)
Calories
4,000-5,000 cal/day
Fluids
Na
Fiber
Caffeine
Hyperthyroidism
Nursing Management
Assessment
Vital signs
Lung sounds
Anxiety level
Weight
Bowel function
NEVER palpate
goiter
Release TH
Hyperthyroidism
Nursing Management
Nrs. Dx
Risk for injury
Hyperthermia
Diarrhea
Alt. Nutrition
Sleep pattern
disturbance
Anxiety
Hyperthyroidism
Nursing Management
Exophthalmos
Lubricate eyes
Tape closed
Dark glasses
Na diet
HOB
Hyperthyroidism
Severe
Thyrotoxicosis
AKA: Thyroid Storm
Definition
Sever hyperthyroid
state
Etiology
Stress
Post thyroid
surgery
Undiagnosed
Hyperthyroidism Severe
Thyrotoxicosis
S&S Depression
TH adrenergic Activity
activity Restlessness
epinephrine Delirium
Pulse SOB
Coma
Temperature
BP
Hyperthyroidism Severe
Thyrotoxicosis
Death
<2hr
Cardiac Failure
Hyperthyroidism Severe
Thyrotoxicosis
Treatment
Fever
Tylenol/
acetaminophen
Not aspirin
For pulse & BP
Propranolol / Inderal
Beta-adrenergic
blocker
If SOB
O2
HOB