CASE STUDY: PRIMARY HYPOTHYROIDISM

Connie, age 28, has been hospitalized for 2 days for symptoms leading to the diagnosis of
primary hypothyroidism.
1. What tests does the nurse know will assist with the confirmation of diagnosis of
primary hypothyroidism for Connie?
- Serum TSH, T3 resin up take test, immuno essay for anti-thyroid antibodies,
radioactive iodine uptake, thyroid scan, radioscan, or scintiscan.
2. What clinical manifestations that are consistent with Connie’s diagnosis should be
monitored?
- Intolerance to cold
- Receding hairline
- Facial and eyelid edema
- Dull blank expression
- Extreme fatigue
- Thick tongue (slow speech)
- Anorexia
- Brittle hair and nails
- Hair loss
- Dry skin (coarse and scaly)
- Apathy
- Lethargy
- Muscle aches and weakness
- Constipation
- Menstrual disturbance
3. What comfort measures can the nurse include in Connie’s care?
- Encouraging frequent periods of rest throughout the day
- Safeguard against the cold
- Control symptoms
- Teach to get oriented to the environment at hand.
4. Connie is ordered Synthroid 0.125 mg orally daily. What education should the nurse
provide?
- Connie must be instructed that over the counter and prescription medications that interact
with Synthroid, must be taken cautiously. There is a decrease in thyroid hormone
absorption when patients are also taking magnesium containing anti-acids.