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3. Hypothyroidism is caused by
4. Hyperthyroidism is caused by
5. Symptoms of hypothyroidism
6. Symptoms of hyperthyroidism
7. Managing Hypothyroidism
8. Managing Hyperthyroidism
9. Complications to look out for: Hypothyroidism
10. Care for Myxedema pt.
11. Complications to look out for: Hyperthyroidism
12. Sx of thyroid storm: DFACT
13. Thyroid storm Management
14. Edu for hypothyroid pt.
15. Edu for hyperthyroidism pt
16. Post op care thyroidectomy
17. causes of hypoparathyroidism
18. Causes of Hyperparathyroidism
19. Sx of hypoparathyroidism
20. Sx of hyperparathyroidism
21. Managing hypoparathyroid
22. Managing Hyperparathyroid
23. Complications of hyperparathyroidism
24. Complications of hypoparathyroidism
25. Hypercalcemic crisis

oligomenorrhea

Anxiety, restless, irritable, fine hand tremors

thyrotoxicosis (excessive T3/T4)

50% pts dont have sx.

emergency tx: Calcitonin+Corticosteroid push

Myxedema : severe hypothyroidism

Fatigue, lethargy, slow speech

radiation to head and neck

pt needs follow up tests

humidified O2

renal calculi (Ca)

avoid coffee, soda, tea, ETOH

bone decalcification

avoid stress and smoking

production stops when concentration increases

psychosis as Ca reaches brain

supplement Ca, and inc it in diet

constipation

bone fracture/ demineralization

tachycardia >130

Thiazides PRN

phosphate retention caused by kidney issue

N and V

coma

Goiter

Autoimmune: Graves

Post op tetany, seizures, resp distress

eat high protein, calorie you're high metabolism

>2L water daiy

damage, atrophy to thyroid

follow up labs and edu pt on sx of inc. Ca

nutrition imbalance

fatigue

Aims at a goal like birth

cold intolerance

Monitor for dyspnea, hematoma, laryngeal nerve injury

thick dry skin, increased hand/feet/tongue size

Combo of antithyroid,radioactive iodine, surgery

permanent hyperthyroidism

Thin skin, finger clubbing

IV fluid with dextrose

eat high Ca foods and take supplements

Ca> 13

increased concentration = increased production

surgical complications

IODINE ( to dec T4 output)

betablocker

Tachycardia, palpitation

Respiratory weakness

Cardiac dysfunction during treatment

look for sx of cardiac issue; meds that inc. metabolism inc. ACS risk

vit D deficiency

production increases when concentration increases

Autoimmune: Hashimoto (most common cause)

avoid thiazides

Bronchospasm

abnormal parathyroid development

eat small frequent foods

iron deficiency

muscle weak

keep pt. moving, weight bearing exercise

careful with sedatives; add to slowed metabolism, resp depression

prevent interaction with adrenergics, warfarin, insulin, estrogen

apathy

Tetany (CVOSTEC, TROUSSEAU)

expressionless mask like face

Hydrocortisone (tx. shock, renal issue)

numbness, tingling, cramps

arrhythmia fixed by IV Ca glutonate pushed SLOWLY

ex: pancreas releasing insulin

fatal

Watch for thyroid storm

change diet to lose weight and dec. constipation

muscle pain

HyperCalcemic crisis

lithium, and other meds taken to fix hyperthyroidism

Avoid cold until pt stable

take meds first thing in the morning on empty stomach

result in neuro, cardio, kidney issue

aims for homeostasis

Give cold liquid, soft food

give IV calcium glutonate to keep Ca (9-10)

parathormone overproduction

edu on menstrual change

cooling blanket, ice pack, cool room

Common-Thyroid Hypertrophy, fixed by thyroidectomy

look for tetany

HTN, dysrythmia

Methimazole (antithyroid)

edu on impact on ADL, psych

tx: Rehydration via IV isotonic

agitation

avoiding infection in PRIORITY

anxiety, depression, irritability

Take rests

Give meds first thing in the morning on empty stomach

Thyroiditis

delirium

decreased metabolism, weight gain

constipation gastric atrophy

Dementia

ex: oxytocin in child birth

Look for bleeding

NO radioactive iodine for preg/lact/planning to concieve

Pt is semifowler, humidifier, reduce talking

Levothyroxine

Heat intolerance

Surgical removal of parathyroid

restrict Ca intake

fever

Meds are lifelong meds, but sx go away in time

toxic adenoma

assess surgical site

recurrent hyperthyroidism

kidney stones/damage

Give vit D

increased metabolism, weight loss

destroyed parathyroids

Avoid milk, egg yolk to dec Phosphorus