ISABELA STATE UNIVERSITY

CITY OF ILAGAN CAMPUS

COLLEGE OF NURSING
BACHELOR OF SCIENCE IN NURSING

CARE OF THE CLIENTS WITH

ENDOCRINE AND METABOLIC
DISORDER
CHARLES Z. ARIOLA JR., RN, MSN, LPT.
THYROID STORM

- Also known as thyrotoxicosis or thyrotoxic crisis

- Form of severe hyperthyroidism usually of abrupt
onset
- Fatal condition if untreated
 SIGNS AND SYMPTOMS
- - fever (38.5 degree celcius) - Dyspnea
- Tachycardia - Palpitations
- Weight loss - Altered neurologic state
- Diarrhea - Frequent delirum psychosis
- Abdominal pain - Somnolence
- Edema - coma
- Chest pain
Life threatening thyroid storm is
usually precipitated by:
- Stress - Diabetic ketoacidosis
- Injury - Pregnancy
- Infection - Digitalis intoxication
- Thyroid or nonthyroid - Abrupt widthrawal of
antithyroid medication
surgery
- Extreme emptional stress
- Tooth extraction
- Vigorous palpatiom of thyroid
- Insulin reaction
 MANAGEMENT
- Ice packs
- Cool environment
- Salicyclates (aspirin) is not used because they displace thyroid
hormone from binding proteins and worsen hypermetablosim
- Humidified oxygen is administered to improve tissue
oxygenation and meet high metabolic demands
- ABG and pulse oximetry
- IVF containing dextrose to replace liver glycogen stores that
have been decreased in the hyperthyroid patient
 MANAGEMENT
- PTU or Methimazole is administered to impede formation of
thyroid hormone and to block the conversion of T4 to T3 which
is a more active form of thyroid hormone
- Hydrocortisone to treat shock or adrenal insufficiency
- Iodine to decrease output of T4
- Propranolol combined with digitalis to reduce severe cardiac
symptoms
 THYROIDITIS
- Inflammation of the thyroid gland which can be acute, subacute
or chronic
- Characterized by autoimmune damage of thyroid
 ACUTE THYROIDITIS

- Rare disorder caused by infection of thyroid gland by bacteria,

fungi, mycobacteria and parasites
- Most common cause is staphylococus aureus
 SIGNS ANS SYMPTOMS
- Anterior neck pain
- Fever
- Dysphagia
- Pharyngitis
- Warmth, redness and tenderness of thyroid gland
 MANAGEMENT
- Antimicrobial agent
- Fluid replacement
- Surgical incision
- Drainage (if with abscess)
 SUBACURTE THYROIDITIS
- Can be subacute granulomatous thyroiditis or painless
thyroiditis (silent thyroiditis) or acute lymphocytic thyroiditis
- Affects women ages 40-50
 SIGNS AND SYMPTOMS
- Painful swelling in anterior neck (1-2 months)
- Respiratory infection
- Enlargement of thyroid glabnd
- Difficulty of swallowing
- Irritability
- Restlessness
- Nervousness
- Insomnia
- Weight loss
- other manifestions of hyperthyroidism
 MANAGEMENT
- NSAIDS
- No aspirin
- Propranolol
- PTU/Methimazole not effective
- Oral corticosteroids
 CHRONIC THYROIDITIS
(HASHIMOTO’S DISEASE)
- Most often in women ages 30-50
- In contrast to acute thyroiditis, chronic is not usually
accompanied by pain, pressure symptoms or fever
- Thyroid activity is normal or low rather than increased
 MANAGEMENT
- Reduction or thyroid gland and prevent hypothyroidism
- Thyroid hormone therapy
- surgery