hyper and hypo tg
TRANSCRIPT
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Objectives:
Students will be able to explain the topic.Students will be able to understand what
it is all about.
Students will be able to differentiate thetopics.
Students will be able to give care to the
patient with that kind of problem.
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The Thyroid Gland
- A butterflyshaped
organ located in thelower neck, anterior to
the trachea
- About 5 cm long and 3cm wide- A highly
vascularize gland (5x >
liver)- This reflects the high
metabolic activity of
the thyroid gland
- This produces 3 hormones:
THYROXINE (T4)
TRIIODOTHYRONINE (T3)
THYROCALCITONIN
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Hyperthyroidism
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-Hyper functioning of the TG-Hyper Secretion of TH
increase levels of T3 and T4. leading increase toBasal metabolism
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CAUSES
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-Autoimmune(graves Dse)
-thyroiditis
-tumor
-infxn-irritates cell leading to increasesecreation of cell
-Radiation-same as infxn
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SIGN AND SYMPTOMS
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WEIGHT LOSS
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HEAT INTOLERANCE OR FEELING WARM
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TACHYCARDIA
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HYPERTENSION
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LOSS OF STRENGTH
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DIAPHORESIS
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EXOPTHALMUS (irreversible)
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Diarrhea ( hyper motility )
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EX. Fear and Irritability
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Thyroid strom
-life threathening all symptoms
become severe.
Complication
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Diagnosis
-Thyroid gland enlarge-T3 & T4 elevated
-RAIU higher than 30%
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Nursing intervention
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1.Must monitor V/S
2.Rest in a quiet room no stressors or stimulus, and to
preserve the clients energy
3.Administer anti thyroid
-methemazole and PTU given with food to preventgastric distress,can cause agranulucytosis or decrease in
production of WBC. Check for any sign of fever, if he has,give paracetamol not aspirin because it convert globulininto thyroid globulin that will increase the secreation of TH.
4.Administer iodine preparation
(lugolssolution) inhibits the synthesis of thyroid hormones
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5.Administer propanolol, for thetachycardia and the HPN
6.DIET
Provide HIGH Caloric and high protein diet
To compensate for the lost enegy
7.Manage Diarrhea with LOW fiber DIET
Cause fiber is bulk forming which mayjust make it worse.
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NOTE: DO NOT MASSAGE PTs THYROID, IT
MAY LEAD TO OVERSECRETION OF TH
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SURGERY AND Treatment
Thyroidectomy- removal of the TG,
1.total- entire TGlarge T that impedes air to the lungs
2.subtotal- a part of the TG will be removed
incision
PRE-OPobtain VS and WT.
Assess for electrolyte levels, glucose levels and T3/T4levels
Teach to support the neck while moving to preventdisruption of the Suture LINE
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Post op
Pxn-semifowlers
Neck in midline only.What to bring?
Tracheostomy set, O2 tank, suction machine and Calciumgluconate to compensate for broncho or laryngo
Check for sign of bleeding, check at nape of the pt.
Assess for hoarseness of voice,acute larygeal nervedamage, instruct the PT to say AHHHHH..usallydone 4-5 days after surgery
Monitor sign of hypocalcemia
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Hypothyroidism
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Hypothyroidism
-Hypo functioning of the TG
-Hypo Secretion of TH
Decrease levels of T3 and T4. leading decreaseto Basal metabolism
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Causes
Autoimmune(hashimotosDse)
Iodine Deficiency-decrease synthesation of
TH
congenital Radiation therapy
Pituitary Dso
Thyroid surgery
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Sign and symptoms
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Lethargy & fatigue
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Cold intolerance
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Weight gain
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Bradycardia
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Dry hair and skin, with hair loss
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Menstrual irregularities
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Generalized puffiness and edema around the
eyes and face
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constipation
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Diagnoses
-low levels of serum T3 &T4
-serum cholesterol level elevated
-RAIU lower than 5%
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Nursing intervention
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1.Monitor VS, especially HR, may lead to coma
2.Administer meds: levothyroxine.best given in
the morning.
3.DIET is LOW calorie,cholesterol and fat.
4.Provide warm environmentexposure to coldmay cause myxedema coma.
5.Manage constipation appropriately. Give high
fiber diet.
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Avoid!
Sedatives
Anesthetics
Narcotics
Stress must be minimizeInfxn
Exposure to extreme cold may lead to
myxedema coma
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TO MAKE A LONG STORY SHORT
Disorders of the
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Disorders of the
THRYROID GLAND
1. Hyperthyrodism
- hypersecretion of thyroidhormone
- common cause is Graves
Dse. (toxic diffuse goiter)
- S/SX
EVERYTHING IS
High
Fast
2. Hypothyroidism
- hyposecretion ofthyroid hormone
- common cause is hashimotosDse.
- MYXEDEMA (adult)
- CRETINISM (child)
- S/SX
EVERYTHING IS
Low
Slow