Hypothyroidism

Question 1

Hypothyroidism (definition)

Answer 1

Disorder that results when the thyroid gland produces insufficient amount of TH

Question 2

Primary Hypothyroidism

Answer 2

Caused by disease (Hashimoto’s disease), or loss of the thyroid gland (thyroidectomy, iodine deficiency, RAI treatment)

Question 3

Secondary Hypothyroidism

Answer 3

Caused by failure of the pituitary TSH deficiency or peripheral resistance to TH

Question 4

Tertiary Hypothyroidism

Answer 4

Failure of the hypothalamus to produce thyroid-releasing factor

Question 5

Hypothyroidism risk factors

Answer 5

• Women (30-60 yrs)
• Use of lithium or amiodarone
• Inadequate intake of iodine
• Family history of autoimmune conditions

Question 6

Hypothyroidism S/S

Answer 6

• Goiter
• Decreased appetite
• Weight gain
• Constipation
• Dry skin
• Pallor
• Hoarseness
• Muscle stiffness
• Slow pulse
• Hyponatremia
• Anemia (low hematocrit)
• Cold intolerance
• Thin, brittle fingernails

Question 7

Myxedema Coma

Answer 7

• Complication of long-standing, untreated hypothyroidism
• Triggered by acute illness or trauma, failure to take thyroid replacement meds, use of CNS depressants, exposure to cold temps.
• S/S: hypothermia, shallow edema, impaired mentation, coma, bradycardia, hypotension

Question 8

Hypothyroidism Diagnostic Tests

Answer 8

• Decrease in T4

- Increase in TSH (primary hypothyroidism)

Question 9

Hypothyroidism Diet

Answer 9

• Low-calorie, high-bulk diet and encourage activity

- Avoid fiber laxatives (interferes with absorption of levothyroxine)

Question 10

Nursing interventions for Hypothyroidism

Answer 10

• Reposition pt every 2 hrs
• Use alcohol-free skin care products
• Provide extra clothing and blankets for pts that are cold (do NOT use electric blankets)
• Prevent constipation: fluid, fiber, activity