Hypothyroidism Flashcards Preview

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Flashcards in Hypothyroidism Deck (22):
1

Hypothyroidism

Deficit

2

Causes

Congenital hypothyroidism
Primary / secondary
Autoimmune*

3

Complication

Myxedema coma

4

Acquired Hypothyroidism

Women
Mild
May progress to life threatmening

5

Primary Hypothyroidism

↓ hormones (thyroid)
Destruction / dysfunction of gland
Radiation ablation
Drugs

6

Secondary Hypothyroidism

Pituitary dysfunction

7

Primary Hypothyroidism Meds

Lithium carbonate
Iodine

8

Hashimoto Thyroiditis

Causes goiter / hypothyroidism
Women
Autoimmune disorder
Hypometabolism state
Myxedematous

9

Manifestations

Intolerance to cold
Facial edema
Dull expression
Fatigue
Thick tongue (slow speech)
Anorexia
Brittleness
Muscle weakness
Constipation

10

Late Manifestations

↓ temp, HR, LOC
↑ weight
Thick skin
Cardiac issues

11

Congenital Hypothyroidism

Needs to be treated in first 6 months
Mental retardation / physical growth

12

Manifestations of Untreated Congenital Hypothyroidism

Cretinism
Jaundice
Mental retardation
Respiratory difficulty
Hoarseness
Enlarged younger
Sluggish
Choking
Large abdomen

13

Improving Outcomes for Congenital Hypothyroidism

Neonatal screening (↑ TSH, ↓ thyroid hormones)
Treat with replacement therapy

14

Diagnostic Tests

H/P
Primary: ↓ T4, ↑ TSH
Antithyroid antibody titer
↑ coritsol, cholesterol
Blood culture, BMP

15

Myxedema Coma

Life threatening
Decompensated state of hypothyroidism

16

Causes of Myxedema Coma

Infx
Stress
Hypothermia
Unconsciousness

17

Manifestations of Myxedema Coma

↓ resp (body doesn’t want to)
Alveolar hypoventilation
CO2 retention
Coma
CV collapse / shock

*check airway

18

Medical Management

Normal metabolic state
Euthyroid state
Prevent progression / complications
IV T3 / T4

19

Levothyroxine

Synthetic T4 salt
↑ metabolic rate, O2 consumption, RR, HR, growth, maturation
Absorbed in GI, excreted in bile
Ok for pregnancy, not lactation
Contraindicated: MI, Addison’s

PO morning w/o food, with water

20

Levothyroxine Adverse FX

Skin / hair issues
Hyperthyroidism
Dysrythymias, HTN
CNS stimulation
Anxiety, sleeplessness, headache
Esophageal irritation

21

Supportive Therapy

O2
IV fluids
Passive warming (blankets)

22

Nursing Management

↑ fiber, ↓ cal
Fluids
Stool softener
Warmth
Slow / precise speech
Monitor TSH
Medication replacement