endocrine Flashcards
hyperthyroidism
fine tremors, heat intolerance, many loose stools daily, diaphoresis, warm moist skin (salmon color), palpitations, rapid pulse at rest
hyperactive DTR, increased appetite, insomnia, weakness, nervous, restless, emotional hyperexcitability, irritable, apprehensive, rapid speech
nursing care hyperthyroidism
monitor SE of meds, S&S of thyroid crisis, place in private room with cold temp, stimulus should be avoided
hypothyroidism
subnormal temp, intolerance to cold, decreased metabolism, dry skin with course, thick, pale, carotene look, thick and brittle nails, hair thins, hypotension and bradycardia, weight gain, paresthesia of fingers, hypoventilation, expressionless face, apathy, large tongue, slow speech, drooling, large goiter
hypothyroidism nursing care
provide high bulk, low calorie diet
administer cathartics/stool softeners
after replacement check for signs of hyperthyroidism
encourage med alert bracelet
prevent myxedema coma
education pt on infection reporting & importance of medication
medication effects not seen for at least 2 weeks, monitor for levothyroxine SE
subtotal thyroidectomy
5/6 part of the thyroid gland is removed
prolonged remission
remaining gland is rutured to trachea
total thyroidectomy
rare
done for thyroid cancer
lifelong hormone replacement therapy
surgery
done for children, adolescents, pregnant women, who cannot tolerate PTU or those who have large goiters causing esophageal compression
risky, may cause nerve damage or hemorrhage
preoperative management
2-3 months
pt placed in euthyroid state with no s&S of hyperthyroidism
helps to decrease size and vascularity of gland
given thionamide 4-6 weeks before surgery
post op patient teaching
coughing and deep breathing
support neck (two sandbags)
discourage unnecessary talking
lifelong thyroid replacement therapy
taken on an empty stomach, 30 minutes before meals
post op management
monitor for hypocalcemia (chvosteks and trousseau’s sign)
airway humidification
suctioning
restrict visitors
increase calories, protein, and carbohydrates
small, frequent meals
monitor weight, I&O
