Hyperthyroidism thyroid disorders .pptx

hyperthyroidism

1. HYPERTHYROIDISM

2. THYROIDITIS 15 to 20% cases. Thyroiditis  is a general term that refers to “inflammation of the thyroid gland”.

3. TREATMENT Goals: – Normalize serum TSH levels . Correct clinical signs & symptoms and metabolic derangements.

4. TREATMENT Steps: Rest Sedation Beta-blockers Antithyroid medication NSAIDs and Corticosteroids

5. SYMPTOMS RELIEF Rehydration is the first step β – blockers to decrease the sympathetic excess. Propranalol , Atenelol , Metoprolol valuable during the first 2–3 weeks of treatment in providing symptomatic relief of tachycardia, nervousness and tremor and can then be discontinued as the specific antithyroid drug becomes clinically effective.

6. ANTI-THYROID MEDICATION Methimazole (MMI) – 5-30 mg daily Propylthiouracil (PTU) – 100-300 mg per day divided BID/TID Side effects : Rash Nausea Vasculitis Liver function tests abnormalities (liver failure with PTU) Agranulocytosis

7. Radio Active Iodine (RAI Rx.) In women who are not pregnant Graves disease not remitting with ATD RAI Rx is the best treatment of hyperthyroidism in adults The effect is less rapid than ATD or Thyroidectomy It is effective, safe, and does not require hospitalization . Given orally as a single dose in a capsule or liquid form. Very few adverse effects as no other tissue absorbs RAI

8. SURGICAL TREATMENT Subtotal Thyroidectomy or Total Thyroidectomy. Total thyroidectomy is an operation that involves the surgical removal of the whole thyroid gland. Subtotal thyroidectomy leaves 3 g to 5 g on the less affected side of the thyroid gland.

9. NURSING MANAGEMENT OF HYPOTHYROIDISM Promote rest.   Promote rest and exercise as tolerated. Protect against coldness.  Provide extra layer of clothing or extra blanket. Avoid external heat exposure.  Discourage and avoid the use of external heat source. Mind the temperature.  Monitor patient’s body temperature.

10. NURSING MANAGEMENT OF HYPOTHYROIDISM Increase fluid intake.  Encourage increased fluid intake within the limits of fluid restriction. Provide foods high in fiber. Manage respiratory symptoms.  Monitor respiratory depth, rate, pattern, pulse oximetry. Pulmonary exercises.  Encourage deep breathing, coughing, and use of incentive spirometry. Orient to present surroundings.  Orient patient to time, place, date, and events around him or her.

11. NURSING MANAGEMENT OF HYPERTHYROIDISM Provide a cool environment . Minimize stress by providing privacy and placing the patient in a private room. Teach patient to avoid stimulants such as coffee, sweets, tea, soft drinks, energy bar and cigarette smoking. Watch out for signs of Agranulocytosis (decrease in WBC) such as sudden onset of fever and sore throat when patient has medications such as PTU or Methimazole. Monitor for other problems such as allergic reactions to drugs, and others. Patient care  post-thyroidectomy