Objectives:

Students will be able to explain the topic.

Students will be able to understand what
it is all about.
Students will be able to differentiate the
topics.
Students will be able to give care to the
patient with that kind of problem.
The Thyroid Gland
- A butterfly shaped
organ located in the
lower neck, anterior to
the trachea
- About 5 cm long and 3
cm wide- A highly
vascularize gland (5x >
liver)
- This reflects the high
metabolic activity of
the thyroid gland

- This produces 3 hormones:

THYROXINE (T4)
TRIIODOTHYRONINE (T3)
THYROCALCITONIN

Hyperthyroidism

-Hyper functioning of the TG
-Hyper Secretion of TH

increase levels of T3 and T4. leading increase to
Basal metabolism

CAUSES
-Autoimmune(graves Dse)
-thyroiditis
-tumor
-infxn-irritates cell leading to increase
secreation of cell
-Radiation-same as infxn

SIGN AND SYMPTOMS
WEIGHT LOSS

HEAT INTOLERANCE OR FEELING WARM

TACHYCARDIA
HYPERTENSION

LOSS OF STRENGTH
DIAPHORESIS

EXOPTHALMUS (irreversible)


Diarrhea ( hyper motility )

EX. Fear and Irritability
Thyroid strom
-life threathening all symptoms
become severe.

Complication
Diagnosis
-Thyroid gland enlarge
-T3 & T4 elevated
-RAIU higher than 30%

Nursing intervention

1.Must monitor V/S

2.Rest in a quiet room no stressors or stimulus, and to
preserve the clients energy

3.Administer anti thyroid
-methemazole and PTU given with food to prevent
gastric distress,can cause agranulucytosis or decrease in
production of WBC. Check for any sign of fever, if he has,
give paracetamol not aspirin because it convert globulin
into thyroid globulin that will increase the secreation of TH.

4.Administer iodine preparation
(lugols solution) inhibits the synthesis of thyroid hormones


5.Administer propanolol, for the
tachycardia and the HPN

6.DIET
Provide HIGH Caloric and high protein diet
To compensate for the lost enegy

7.Manage Diarrhea with LOW fiber DIET
Cause fiber is bulk forming which may
just make it worse.
NOTE: DO NOT MASSAGE PTs THYROID, IT
MAY LEAD TO OVERSECRETION OF TH

SURGERY AND Treatment
Thyroidectomy- removal of the TG,
1.total- entire TG
large T that impedes air to the lungs
2.subtotal- a part of the TG will be removed
incision
PRE-OP
obtain VS and WT.
Assess for electrolyte levels, glucose levels and T3/T4
levels
Teach to support the neck while moving to prevent
disruption of the Suture LINE

Post op
Pxn-semifowlers
Neck in midline only.
What to bring?
Tracheostomy set, O2 tank, suction machine and Calcium
gluconate to compensate for broncho or laryngo

Check for sign of bleeding, check at nape of the pt.
Assess for hoarseness of voice,acute larygeal nerve
damage, instruct the PT to say AHHHHH..usally
done 4-5 days after surgery

Monitor sign of hypocalcemia

Hypothyroidism
Hypothyroidism
-Hypo functioning of the TG
-Hypo Secretion of TH

Decrease levels of T3 and T4. leading decrease
to Basal metabolism
Causes
Autoimmune(hashimotos Dse)
Iodine Deficiency-decrease synthesation of
TH
congenital
Radiation therapy
Pituitary Dso
Thyroid surgery
Sign and symptoms


Lethargy & fatigue
Cold intolerance
Weight gain
Bradycardia

Dry hair and skin, with hair loss

Menstrual irregularities
Generalized puffiness and edema around the
eyes and face
constipation
Diagnoses
-low levels of serum T3 &T4
-serum cholesterol level elevated
-RAIU lower than 5%
Nursing intervention
1.Monitor VS, especially HR, may lead to coma
2.Administer meds: levothyroxine.best given in
the morning.
3.DIET is LOW calorie,cholesterol and fat.
4.Provide warm environment exposure to cold
may cause myxedema coma.
5.Manage constipation appropriately. Give high
fiber diet.
Avoid!
Sedatives
Anesthetics
Narcotics
Stress must be minimize
Infxn
Exposure to extreme cold may lead to
myxedema coma
TO MAKE A LONG STORY SHORT
Disorders of the
THRYROID GLAND
1. Hyperthyrodism
- hypersecretion of thyroid
hormone
- common cause is Graves
Dse. (toxic diffuse goiter)


- S/SX

EVERYTHING IS
High
Fast
Wet
2. Hypothyroidism
- hyposecretion of
thyroid hormone

- common cause is hashimotos
Dse.
- MYXEDEMA (adult)
- CRETINISM (child)
- S/SX

EVERYTHING IS
Low
Slow
Dry