Question

Joe Clark, a 56-year-old male client, is newly diagnosed with primary hypothyroidism. He is a principal at a local high school. The laboratory results included TSH, 22 mIu/L (normal range: <7 mIu/L); T4, 3.5 mcg/d (normal range: 5 to12 mcg/dL); Total T3, 75 mcg/dL (normal range: 80 to 220 mcg/dL); Free T4 or FT4, 0.5 mcg/dL (normal range: 0.7 to 2.0 mcg/dL); and Free T3, 1.7 mcg/dL (normal range: 2.3 to 4.2 mcg/dL). The vital signs are T, 97° F; BP, 92/50 mm Hg; HR (Apical pulse), 58 beats/minute and regular; RR, 12 breaths/minute. He stated that since his last visit to the clinic 2 days earlier, he has noticed that he has constipation and that his weight has increased another 3 lb despite eating very little because he has no appetite. He also stated that he is so tired he has trouble staying awake at work. He has problems remembering important things to do during the day. He also feels like he has an unusual quick temper toward others. He has a masklike face and periorbital edema, and the tongue is slightly enlarged. The client’s feet and hands are puffy and cold to touch. He asks the LPN/LVN to tell him how to manage hypothyroidism and more about the new medication, levothyroxine (Synthroid).

Explain why the TSH, T3, and T4 indicate the client has hypothyroidism.

What is the cause of goiter?

What signs and symptoms indicate Joe Clark has hypothyroidism? Explain at least 4.

What is the name of the medication a client will take for hypothyroidism?

What directions will you give Mr. Clark about his new medication?

If Mr. Clark does not take his medication or has an infection what is the life-threatening condition that can develop? What signs and symptoms would he have if he has this condition? List 3 signs and symptoms and discuss the nursing interventions related to these 3 signs and symptoms

I'm not understanding

Answer 1

Explain why the TSH, T3, and T4 indicate the client has hypothyroidism.

Primary hypothyroidism is virtually the only disease that is characterized by sustained rises in TSH levels. As the TSH level increases early in the disease, conversion of T4 to T3 increases, maintaining T3 levels. In early hypothyroidism, TSH levels are elevated, T4 levels are normal to low, and T3 levels are normal.

What causes a goiter?

Iodine deficiency is the main cause of goiters. . When don’t have enough iodine, the thyroid works extra hard to make thyroid hormone, causing the gland to grow larger.

Other causes include the following:

Graves’ disease

Graves’ disease occurs when thyroid produces more thyroid hormone than normal, which is known as hyperthyroidism. The excessive production of hormones makes the thyroid increase in size.

Hashimoto’s thyroiditis

The Hashimoto’s thyroiditis, also known as Hashimoto’s thyroiditis, it predisposes thyroid to not being able to produce enough thyroid hormone, causing hypothyroidism.

The low thyroid hormone causes the pituitary gland to make more thyroid-stimulating hormone (TSH), which causes the thyroid to enlarge.

Inflammation

Some people develop thyroiditis, an inflammation of the thyroid that can cause a goiter. example is viral thyroiditis.

Nodules

The solid or fluid-containing cysts may appear on the thyroid and cause it to swell. These nodules are often noncancerous.

Thyroid cancer

Cancer may affect the thyroid, which causes swelling on one side of the gland.

Pregnancy

Being pregnant can sometimes cause the thyroid to become larger.

What signs and symptoms indicate Joe Clark has hypothyroidism? Explain at least 4.

Constipation is a problem that can be particularly troublesome with underactive thyroid, a condition called hypothyroidism. Hypothyroidism slows down many of your body's systems, including digestion and elimination.it leads to reduced gut mobility.

weight gained in hypothyroid individuals is due to excess accumulation of salt and water. Massive weight gain is rarely associated with hypothyroidism. In general, 5-10 pounds of body weight may be attributable to the thyroid, depending on the severity of the hypothyroidism.

Periorbital edema is the common symptoms in hypothyroidism and can cause fluid retention in the body, including around the eyes. Periorbital cellulitis is a serious skin condition caused by infection and inflammation of the eyelid and the skin around the eyes. This can result in periorbital edema.

Enlarged tongue this thyroid disorder is characterized by low levels of thyroid hormone. When thyroid hormone levels are low, you may experience the following symptoms in addition to tongue swelling and scalloped edges, hair loss. tiredness.

What is the name of the medication a client will take for hypothyroidism?

Joe clark has to take levothyroxin . Levothyroxin is a drug that is actually the genetic counterpart of T4 hormone.commonly used to treat hypothyrodism.

What directions will you give Mr. Clark about his new medication?

1) levothyroxin must take in empty stomach or minimum 30 mins before taking breakfast.

2) levothyroxin have to take orally , take the tablet in whole , it should not be crushed .

3) some foods should be avoided like grapefruit juice , walnuts,or high fibre foods.

4) levothyroxin should not be taken with any other weightloss medication .

5) Missed dose should be taken as soon as possible after remembering .but it should not be taken if the time of next dose of medication come closer , it should be taken in double dose 6 ) it should not be taken if there is any symptoms of heart attack , or any kind of adrenal disorder .

7) some medication like calcium carbonate , heparin , propanolol , androgens, antacid with magnesium ,with levothyroxin so must inform doctors of you are taking this medicines .

8) levothyroxin on has certain sideffects which are mainly found in levothyroxin overdose like chest pain, anxiety , shortness of breath , difficulty in sleep wake cycle , confusion, nervousness, irritability ,siezure etc .so in that case must inform doctor.

9) the medicine should be taken 4 hour earlier if taking any counter medicine or any vitamin or any herbal medicine .

10) rest should be taken , regular follow up to doctors should be done .

11) During taking medicine dose , mfg date , name of medicine , expiary date should be checked properly .

If Mr. Clark does not take his medication or has an infection what is the life-threatening condition that can develop? What signs and symptoms would he have if he has this condition? List 3 signs and symptoms and discuss the nursing interventions related to these 3 signs and symptoms

The rare, severe untreated hypothyroidism can lead to a life-threatening condition called myxedema, a type of coma that occurs when the body's level of thyroid hormones becomes extremely low

Signs and symptoms

A person with myxedema may notice swelling in their face, legs, or tongue. Their skin may also become dry and pale.

Other symptoms of severe hypothyroidism can include:

intolerance to cold

tiredness

weight gain

drooping eye

shock

decreased breathing

confusion

apathy or depression

psychosis

constipation

coarse hair

goiter

low energy

seizures

reduced mobility

coma

low body temperature

Myxedema can also lead to low oxygen and high carbon dioxide levels in the blood.

Nursing diagnosis

Excess fluid volume related to accumulation of water and sodium as manifested by facial,legs swelling.

Constipation related to decreased gut mobility as evidenced by patient verbalization.

Fatigue related to lethargy as evidenced by patient verbalization

These are the nursing diagnosis