THYROID DISTURBANCE

SISTEM ENDOKRIN
 Secretions of the thyroid gland…
Thyroxine (T4) and
Triiodothyronine (T3) controlled by
TSH: Essential to BMR (Basal
Metabolic Rate), Regulate Body
Temperature, Influences physical/
Mental Development and Growth

Calcitonin: Influences calcium

metabolism; maintains a
homeostasis of calcium in the
blood plasma, bone & tooth
formation, muscle and nerve
activity, and blood clotting
 Thyroid Disorders
• Cretinism- hypothyroidism in infants, leads to
small stature and mental retardation
• Goiter- simple adult hypothyroidism, iodine
deficiency
• Myxedema- adult hypothyroidism, low
metabolic rate, sluggishness
• General Hyperthyroidism (Grave’s
Disease)- high metabolic rate, hyperactivity,
weight loss, protruding eyes
 Cretinism

• Result from thyroid hormone

insufficiency in infancy
 Goiter

• Iodine deficiency in your diet results in

goiter (enlargement of thyroid gland)
 Myxedema
• Hypothyroidsm
increased amount of protein and mucopolysaccharides
in dermis   water binding  nonpitting edema, thickening
of the tongue, and the laryngeal and pharyngeal mucous
membranes  thick slurred speech and hoarseness
 Grave’s Disease
Leads to anxiety, irritability, tremor, weight loss, insomnia,
rapid or irreguler heartbeat, & severe stress; eyeballs tend
to bulge and a goiter (enlarged thyroid gland) forms
 Endocrine Emergencies

 Thyroid Storm
– Life threatening, sudden onset of thyroid hyperactivity)

 Myxedema Coma
– Life threatening, sudden onset of thyroid hypoactivity)
HYPERTHYROIDSM vs HYPOTHYROIDSM
 HYPERTHYROIDISM
Pharmacologic Therapy
• Radioactive iodine ablation is usual treatment
surgery or medical therapy are options
 HYPERTHYROIDISM
Pharmacologic Therapy
• Propylthiouracil (PTU):
Start 100 po tid, then adjust up to 200 po tid as needed
• Methimazole (Tapazole):
Start 5–20 mg po tid, then adjust
• β-blockers or calcium antagonists:
adjunctive therapy....for symptomatic improvement
• Glucocorticoid
adjunctive therapy....for symptomatic improvement
HYPERTHYROIDISM
Surgery Therapy
 HYPOTHYROIDISM
Pharmacologic Therapy
Levothyroxine (T4, levothyroxine Eltroxin, Levo-T, Levothroid,
Levoxyl, Synthroid]).
-Start at 25 mcg and increase by 25 mcg intervals q 6-8 wk
For myxedema coma:
-Load 400 mcg IV or 100 mcg q 6–8 h for 1 d, then 100 mcg/d for 4
d; then start usual replacement regimen.
To convert thyroid USP to thyroxine:
-60 mg USP = 50 mcg thyroxine.
PO to IV
If patients are NPO and must receive IV thyroxine;
-dose should be half usual po dose.
.
 NCP - HYPERTHYROIDSM

https://nurseslabs.com/7-hyperthyroidism-nursing-care-plan-ncp/2/
 NCP - HYPERTHYROIDSM

https://nurseslabs.com/7-hyperthyroidism-nursing-care-plan-ncp/2/
NCP - HYPOTHYROIDSM

https://nurseslabs.com/hypothyroidism-nursing-care-plans/
 Any
Question?