Hypothyroidism

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1

Define hypothyroidism.

Levels of T3 and T4 in the blood stream are too low and causes a decrease in the metabolic rate

2

Hypothyroidism is often undiagnosed in ____________ clients.

Older

3

What are the three kinds of hypothyroidism?

Primary - disfunction of the thyroid gland or loss of.

Secondary - failure of the anterior pituitary gland to stimulate the thyroid.

Tertiary - failure of the hypothalamus to produce TSH

4

What age group is most affected by hypothyroidism?

women 30-60 years old

5

In hypothyroidism, the hormone disturbance can contribute to an acceleration of ___________ .

atherosclerosis

6

These two medications can cause hypothyroidism.

lithium and amiodarone

7

Radiation therapy to the _________ and ____________ can increase the possibility of getting hypothyroidism.

head

neck

8

True or false: Hypothyroidism is often characterized by vague and varied findings that develop slowly over time.

True

9

What are some expected findings for a patient with hypothyroidism?

fatigue/ lethargy

irritability

Cold intolerance

constipation

weight gain without caloric intake increase

pale, dry, flakey skin

thick brittle finger nails

depression/apathy

periorbital edema

horse raspy speech

decreased libido

10

What is a normal T3 range in adults?

ages 20-50: 70-205

ages older than 50: 40-180

11

What is normal T4 range in adults?

4-12 in men

5-12 in women

12

What lab level is raised by hypothyroidism?

serum cholesterol

13

What two diagnostic procedures can be done to help determine if a client has hypothyroidism?

Nuc med radioisotope uptake

ECG

14

What nursing care should you consider when you have a client who has hypothyroidism?

Monitor for cardiovascular changes

Monitor for weight changes

Assess mental status

Increase activity level gradually

Apply compression stockings

Monitor respiratory status

Provide low calorie, high bulk diet

administer stool softeners as needed

Provide meticulous skin care

15

What laxative should you avoid for a patient who has hypothyroidism?

Fiber laxatives

16

Why should hypothyroidism clients avoid electric blankets?

because the combination of vasodilation, decreased sensation, and decreased alertness can lead to unrecognized burns.

17

What medication is used to treat hypothyroidism?

levothyroxine

18

Levothyroxine increases the effects to the medication ______________ but can also increase the need for ____________ and __________.

warfarin

insulin

digoxin

19

What nursing consideration should you take into account when giving levothyroxine?

Monitor for cardiovascular compromise

20

What client education should you give when administering levothyroxine.

Instruct client to begin treatment slowly and that the dosage is increased every 2-3 weeks.

Take on an empty stomach

fiber supplements, calcium, iron and antacids interfere with absorption

monitor for S&S of hyperthyroidism

21

This is a life threatening condition that occurs when hypothyroidism is left untreated.

Myxedema

22

What are the manifestations of myxedema?

Respiratory failure

hypotension

hypothermia

bradycardia

hyponatremia

hypocalcemia

coma

23

When a patient is in myxedema, how will you give levothyroxine?

large dose IV bolus