Question

Use the disorder of the system Active Learning Template for Hypothyroidism and complete following sections:

 Alterations in Health

 Pathophysiology Related to Client Problem

 Health Promotion & Disease Prevention  Assessment o Risk Factors o Expected Findings o Laboratory Tests o Diagnostic Procedures  Patient-Centered Care o Medication Write an analysis describing how the levothyroxine class relates to the hypothyroidism selected systems disorder. 300 words minimum.

Answer 1

HYPOTHYROIDISM

DEFINITION

UNDER ACTIVE THROID GLAND T3 AND T4.HYPOTHYROIDISM RESULTS FROM SUBOPTIMAL LEVELS OF THYROID HORMONE.THYROID DEFICIENCY CAN AFFECT ALL BODY FUNCTIONS AND CAN RANGE FROM MILD ,SUBCLINICAL FORMS TO MYXEDEMA ,AN ADVANCED FORM.THE MOST COMMON CAUSE OF HYPOTHYROIDISM IN ADULTS IS AUTOIMMUNE THYROIDITIS (HASHIMOTO'S DISEASE) ,IN WHICH THE IMMUNE SYSTEM ATTACKS THE THROID GLAND

PATHOPHYSIOLOGY

THE PATHOPHYSIOLOGY OF HYPOTHROIDISM IS CHARACTERISED BY MAINLY REDUCTION OF THE BASAL MATABOLIC RATE AND GENERALIZED MYXEDEMA.TYPICAL CLINICAL FINDINGS INCLUDE FATIGUE , COLD INTOLERANCE ,WEIGHT GAIN , AND PERIORBITAL EDEMA.HYPOTHYROIDISM CAN BE ALSO COMMONLY OCCUR IN PATIENTS WITH PREVIOUS HYPERTHROIDISM THAT HAS BEEN TREATED WITH RADIOIODINE OR ANTITHYROID MEDICATIONS OR THYROIDECTOMY.

CAUSES OF HYPOTHYROIDISM

• HASHIMOTO'S THYROIDITIS,POST GRAVE'S DISEASE
• ATROPHY OF THYROID GLAND WITH AGING
• THERAPY FOR HYPERTHROIDISM

   1. RADIOACTIVE IODINE

   2. THYROIDECTOMY

• MEDICATIONS

​​​​​​​   1. LITHIUM

   2. IODINE COMPOUNDS

3. ANTITHYROID MEDICATIONS

• RADIATION TO HEAD AND NECK FOR TREATMENT OF HEAD AND NECK CANCERS,LYMPHOMA
• INFILTRATIVE, DISEASES OF THYROID ( AMYLOIDOSIS , SCLERODERMA,LYMPHOMA)
• IODINE DEFICIENCY AND IODINE EXCESS

​​​​​​​ CLINICAL MANIFESTATIONS

REQUIRES A MEDICAL DIAGNOSIS

MAJOR SYMPTOMS INCLUDE FATIGUE,COLD SENSITIVITY,CONSTIPATION,DRY SKIN, AND UNEXPLAINED WEIGT GAIN.

PEOPLE MAY EXPERIANCE

WHOLE BODY : FATIGUE ,LETHARGY,OR FEELING COLD

DEVELOPMENTAL : DELAYED PUBERTY OR SLOW GROWTH

HAIR : HAIR LOSS OR DRYNES

ALSO COMMON:

• BRITTLE NAILS
• CONSTIPATION
• DRY SKIN
• ENLARGED THYROID
• HIGH CHOLESTEROLE
• IREGULAR UTERINE BLEEDING
• IRRITABILITY
• SENSITIVITY TO COLD
• SEXUAL DYSFUNCTION
• SLOW HEART RATE
• SLUGGISHNESS
• WEIGHT GAIN

​​​​​​​​​​​​​​LABORATORY AND DIAGNOSTIC STUDIES

THYROID TESTS

• SERUM THYROID STIMULATING HORMONE
• SERUM FREE T4
• SERUM T3 AND T4
• T3 RESIN UPTAKE TEST
• THYROID ANTIBODIES
• RADIOACTIVE IODINE UPTAKE
• FINE NEEDLE ASPIRATION BIOPSY
• THYROID SCAN, RADIOSCAN,OR SCINTISCAN
• ​​​​​​​SERUM THYROGLOBULIN

​​​​​​​​​​​​​​MEDICAL MANAGEMENT

THE PRIMARY OBJECTIVEIN THE MANAGEMENT OF HYPOTHYROIDISM IS TO RESTORE A NORMAL MATABOLIC STATE BY REPLACING THE MISSING HORMONE

PHARMACOLOGIC THERAPY

SYNTHETIC LEVOTHYOXINE IS THE PEFERRED PREPARATION FOR TREATING HYPOTHYROIDISM AND SUPPRESSING NONTOXIC GOITERS .THE DOSAGE FOR HORMONE REPLACEMENT IS BASED ON THE PATIENT'S SERUM TSH CONCENTRATION.DESICCATED THYROID IS USED INFREQUENTLY TODAY,BECAUSE IT OFTEN RESULTS IN TRANSIENT ELEVATED SERUM CONCENTRATION OF T3,WITH OCCASIONAL SMYPTOMS OF MYXEDEMA DISAPPEAR AND NORMAL METABOLIC ACTIVITYIS RESUMED.

PREVENTION OF CARDIAC DYSFUNCTION

THE NURSE MUST MONITOR FOR MYOCARDIAL ISCHEMIA OR INFARCTION ,WHICH CAN OCCUR IN RESPONSE TO THERAPY IN PATIENTS WITH SEVERE ,LONG -STANDING HYPOTHROIDISM OR MYXEDEMA COMA.THE NURSE MUST ALSO BE ALERT FOR SIGNS OF ANGINA ,ESPECIALLY DURING THE EARLY PHASE OF TREATMENT ; IF DETECTED ,IT MUST BE REPORTED AND TREATED AT ONCE TO AVOID A FATAL MYOCARDIAL INFARCTION.