HYPOTHY R OID IS M

, TURAL L O, YA D IS, YB UT
GROUP 4- SIMON, SOTTO
DESCRIPTION
• RESULTS FROM HYPOTHALAMIC, PITUITARY, OR THYROID INSUFFICIENCY OR
RESISTANCE TO THYROID HORMONE

• CAN PROGRESS TO LIFE-THREATENING MYXEDEMA COMA

• MORE PREVALENT IN WOMEN THAN MEN
• INCIDENCE IS INCREASING SIGNIFICANTLY IN US IN PEOPLE AGES 40-50
• OCCURS PRIMARILY AFTER AGES 40.
• AFTER AGES 65, PREVALENCE INCREASES TO AS MUCH AS 10% IN FEMALES, 3% IN
MALES
• IT IS ALSO A COMMON CONDITION WHERE THE THYROID DOESN’T CREATE AND
RELEASE ENOUGH THYROID HORMONE INTO YOUR BLOODSTREAM. THIS MAKES YOUR
METABOLISM SLOW DOWN. ALSO CALLED UNDERACTIVE THYROID, HYPOTHYROIDISM
CAN MAKE YOU FEEL TIRED, GAIN WEIGHT AND BE UNABLE TO TOLERATE COLD
TEMPERATURES. THE MAIN TREATMENT FOR HYPOTHYROIDISM IS HORMONE
REPLACEMENT THERAPY.
 SIGNS AND SYMPTOMS
• TACHYCARDIA
• PALPITATIONS
• ATRIAL FIBRILLATION
• NERVOUSNESS
• TIREDNESS
• HEADACHE
• INCREASED EXCITABILITY
• SLEEPLESSNESS
• TREMORS
• POSSIBLE ANGINA
• MUSCLE WEAKNESS -MUSCLE ACHES, TENDERNESS AND STIFFNESS
RISK FACTORS
• HAVING A FAMILY HISTORY OF THYROID DISEASE.
• HAVING A FAMILY HISTORY OF AUTOIMMUNE DISEASE.
• HAVING AN AUTOIMMUNE DISEASE.
• BEING OF CAUCASIAN OR ASIAN ETHNICITY.
• BEING FEMALE.
• BEING OLDER THAN AGE 60
• EXPOSURE TO RADIATION IN THE NECK.
• PRIOR THYROID SURGERY.
PATHOPHYSIOLOGY
• WHEN THYROID DYSFUNCTION IS CAUSED BY FAILURE OF THE PITUITARY GLAND, THE
HYPOTHALAMUS, OR BOTH, IT IS KNOWN AS CENTRAL HYPOTHYROIDISM.

• IT MAY BE REFERRED TO AS PITUITARY OR SECONDARY HYPOTHYROIDISM IF IT IS

CAUSED ENTIRELY BY A PITUITARY DISORDER, AND HYPOTHALAMIC OR TERTIARY
HYPOTHYROIDISM IF IT IS ATTRIBUTABLE TO A DISORDER OF THE HYPOTHALAMUS

• RESULTING IN INADEQUATE SECRETION OF TSH BECAUSE OF DECREASED STIMULATION

BY TRH.
• WHEN THYROID DEFICIENCY IS PRESENT AT BIRTH, THE CONDITION IS KNOWN AS
CRETINISM. IN SUCH INSTANCES, THE MOTHER MAY ALSO SUFFER FROM THYROID
DEFICIENCY.

• THE TERM MYXEDEMA REFERS TO THE ACCUMULATION OF MUCOPOLYSACCHARIDES IN

SUBCUTANEOUS AND OTHER INTERSTITIAL TISSUES.

• ALTHOUGH MYXEDEMA OCCURS IN LONG-STANDING HYPOTHYROIDISM, THE TERM IS

USED APPROPRIATELY ONLY TO DESCRIBE THE EXTREME SYMPTOMS OF SEVERE
HYPOTHYROIDISM
LABORATORY AND DIAGNOSTIC TEST
DRUG STUDY
SURGICAL MANAGEMENT

• SURGERY IS RARELY NEEDED IN PATIENTS WITH HYPOTHYROIDISM; IT IS MORE

COMMONLY REQUIRED IN THE TREATMENT OF HYPERTHYROIDISM.
HOWEVER, SURGERY IS INDICATED FOR LARGE GOITERS THAT COMPROMISE
TRACHEOESOPHAGEAL FUNCTION.
MEDICAL MANAGEMENT
• MONITORING ABG VALUES, AND ADMINISTERING FLUIDS CAUTIOUSLY BECAUSE OF THE
DANGER OF WATER INTOXICATION.

• SYNTHETIC LEVOTHYROXINE (SYNTHROID OR LEVOTHROID) IS THE PREFERRED

PREPARATION.

• EXTERNAL HEAT APPLICATION IS AVOIDED BECAUSE IT INCREASES OXYGEN

REQUIREMENTS AND MAY LEAD TO VASCULAR COLLAPSE.

• CONCENTRATED GLUCOSE MAY BE GIVEN IF HYPOGLYCEMIA IS EVIDENT.

• IF MYXEDEMA COMA IS PRESENT, THYROID HORMONE IS GIVEN INTRAVENOUSLY UNTIL
CONSCIOUSNESS IS RESTORED
 NURSING MANAGEMENT
• ORAL AND WRITTEN INSTRUCTIONS SHOULD BE PROVIDED REGARDING
• THE FOLLOWING:
• DESIRED ACTIONS AND SIDE EFFECTS OF MEDICATIONS
• CORRECT MEDICATION ADMINISTRATION
• IMPORTANCE OF CONTINUING TO TAKE THE MEDICATIONS AS PRESCRIBED EVEN AFTER SYMPTOMS IMPROVE
• WHEN TO SEEK MEDICAL ATTENTION
• IMPORTANCE OF NUTRITION AND DIET TO PROMOTE WEIGHT LOSS AND NORMAL BOWEL PATTERNS
• IMPORTANCE OF PERIODIC FOLLOW-UP TESTING THE PATIENT AND FAMILY SHOULD BE INFORMED THAT MANY
OF THE SYMPTOMS OBSERVED DURING THE COURSE OF THE DISORDER WILL DISAPPEAR WITH EFFECTIVE
TREATMENT.
• CONTINUING CARE
• MONITOR THE PATIENT’S RECOVERY AND ABILITY TO COPE WITH THE RECENT CHANGES,
ALONG WITH THE PATIENT’S PHYSICAL AND COGNITIVE STATUS AND THE PATIENT’S AND
FAMILY’S UNDERSTANDING OF THE INSTRUCTIONS PROVIDED BEFORE HOSPITAL
DISCHARGE.
• DOCUMENT AND REPORT TO THE PATIENT’S PRIMARY HEALTH CARE PROVIDER SUBTLE
SIGNS AND SYMPTOMS THAT MAY INDICATE EITHER INADEQUATE OR EXCESSIVE THYROID
HORMONE.
NURSING CARE PLANS