Your SlideShare is downloading. ×
0
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Lecture 5B (Thyroid Gland) PowerPoint
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Lecture 5B (Thyroid Gland) PowerPoint

8,758

Published on

Published in: Health & Medicine
0 Comments
6 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
8,758
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
310
Comments
0
Likes
6
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Thyroid part 2 Hypothyroidism
  • 2. Hypothyroidism <ul><li>Definition </li></ul><ul><li> TH </li></ul><ul><li>Pathophysiology </li></ul><ul><li>Primary hypothyroidism </li></ul><ul><ul><li>Thyroid fails to produce enough TH </li></ul></ul><ul><li>Secondary Hypothyroidism </li></ul><ul><ul><li> stimulation  Thyroid (pituitary or hypothalmus) </li></ul></ul>
  • 3. Hypothyroidism <ul><li>Etiology </li></ul><ul><li>Primary </li></ul><ul><ul><li>Congenital </li></ul></ul><ul><ul><li>I deficiency </li></ul></ul><ul><ul><li>Auto-immune </li></ul></ul><ul><ul><li>Thyroidectomy </li></ul></ul><ul><li>Secondary </li></ul><ul><ul><li>Pituitary / hypothalamus </li></ul></ul>
  • 4. Hypothyroidism <ul><li>S&S </li></ul><ul><li>Think ______ </li></ul><ul><ul><li>Slow </li></ul></ul>
  • 5. Hypothyroidism S&S <ul><li>Neurology </li></ul><ul><li>Slow mentation </li></ul><ul><li>Slurred speech </li></ul><ul><li>Affect </li></ul><ul><li>Lethargy </li></ul><ul><li>depression </li></ul>
  • 6. Hypothyroidism S&S <ul><li>Cardiovascular </li></ul><ul><li>Bradycardia </li></ul><ul><li>Gastro-intestinal </li></ul><ul><li>Constipation </li></ul><ul><li>Weight gain </li></ul><ul><li>Appetite loss </li></ul>
  • 7. Hypothyroidism S&S <ul><li>Muscular-skeletal </li></ul><ul><li>Clumsy slow movements </li></ul><ul><li>Fatigue </li></ul><ul><li>Cold intolerance </li></ul><ul><li>Dull facial expression </li></ul>
  • 8. Hypothyroidism S&S <ul><li>Skin </li></ul><ul><li>Dry, pale </li></ul><ul><li>Hair dry </li></ul><ul><li>Thick lips </li></ul><ul><li>Puffy eyes </li></ul>
  • 9. Hypothyroidism <ul><li>Cretinism </li></ul><ul><li>Rare in the US </li></ul><ul><li>Congenital condition d/t  TH  physical & mental retardation </li></ul><ul><li>18yr old </li></ul>
  • 10. Hypothyroidism <ul><li>Hashimoto’s thyroiditis </li></ul><ul><li>Most common adult hypothyroidism </li></ul><ul><li>Auto-immune </li></ul><ul><li>Female > male </li></ul><ul><li>Age: </li></ul><ul><ul><li>30-50 </li></ul></ul>
  • 11. Hypothyroidism Diagnostic Tests <ul><li>By definition hypothyroidism means what? </li></ul><ul><ul><li>T3/T4 </li></ul></ul><ul><ul><li> </li></ul></ul>Primary Hypothyroidism Secondary Hypothyroidism T3/T4  TSH
  • 12. Hypothyroidism Diagnostic Tests <ul><li>By definition primary hypothyroidism means what? (where is the problem – what is causing the problem?) </li></ul><ul><ul><li>Thyroid  </li></ul></ul><ul><ul><ul><li> T3/T4 </li></ul></ul></ul><ul><li>In primary hypothyroidism, is the pituitary gland working correctly? </li></ul><ul><ul><li>Yes </li></ul></ul>
  • 13. Hypothyroidism Diagnostic Tests <ul><li>If the pituitary gland is working correctly and there is an  T3/T4 level, what will the Pituitary gland do with the TSH level? </li></ul>Primary Hypothyroidism Secondary Hypothyroidism T3/T4  TSH 
  • 14. Hypothyroidism Diagnostic Tests <ul><li>By definition hypothyroidism means what? </li></ul><ul><ul><li>T3/T4 </li></ul></ul><ul><ul><li> </li></ul></ul>Primary Hypothyroidism Secondary Hypothyroidism T3/T4   TSH 
  • 15. Hypothyroidism Diagnostic Tests <ul><li>By definition secondary hypothyroidism means what? (where is the problem – what is causing the problem?) </li></ul><ul><ul><li>Pituitary gland  </li></ul></ul><ul><ul><ul><li> TSH  </li></ul></ul></ul><ul><ul><ul><li> T3/T4 </li></ul></ul></ul>
  • 16. Hypothyroidism Diagnostic Tests <ul><li>By definition secondary hyporthyroidism means what? (where is the problem – what is causing the problem?) </li></ul><ul><ul><li>Pituitary gland   TSH   T3/T4 </li></ul></ul>Primary Hypothyroidism Secondary Hypothyroidism T3/T4   TSH  
  • 17. Hypothyroidism Medical Treatment <ul><li>Rx / life time </li></ul><ul><li>Thyroid (Armour thyroid) </li></ul><ul><ul><li>Natural form </li></ul></ul><ul><li>Levothyroxine sodium / Levothroid, Synthroid </li></ul><ul><ul><li>Synthetic </li></ul></ul><ul><li>Time of dose </li></ul><ul><ul><li>AM </li></ul></ul><ul><li>Monitor __________system </li></ul><ul><ul><li>C/V </li></ul></ul><ul><li>Gradually  meds </li></ul><ul><ul><li>takes 2 wks to know full affect </li></ul></ul><ul><li>Blood level monitoring </li></ul><ul><ul><li>Annually </li></ul></ul><ul><li>Know S&S and report </li></ul>
  • 18. Hypothyroidism Medical Treatment <ul><li>Diet </li></ul><ul><li>Fiber </li></ul><ul><ul><li> </li></ul></ul><ul><li>Protein </li></ul><ul><ul><li> </li></ul></ul><ul><li>Fluids </li></ul><ul><ul><li> </li></ul></ul><ul><li>Calories </li></ul><ul><ul><li> </li></ul></ul><ul><li>Avoid food  in I (interferes with meds) </li></ul>
  • 19. <ul><li>Avoid food  in I </li></ul><ul><ul><li>Kelp </li></ul></ul><ul><ul><li>Shellfish </li></ul></ul><ul><ul><li>Iodized salt </li></ul></ul><ul><ul><li>Cabbage </li></ul></ul><ul><ul><li>Turnips </li></ul></ul><ul><ul><li>Pears </li></ul></ul><ul><ul><li>Peaches </li></ul></ul>
  • 20. Hypothyroidism Nursing management <ul><li>Rest </li></ul><ul><ul><li>Space </li></ul></ul><ul><li>Skin </li></ul><ul><ul><li>Protect </li></ul></ul><ul><li>Diet </li></ul><ul><ul><li>Adjust </li></ul></ul>
  • 21. Severe Hypothyroid State <ul><li>Myxedema </li></ul><ul><li>Definition </li></ul><ul><ul><li>Advanced hypothyroidism </li></ul></ul><ul><li>Etiology </li></ul><ul><ul><li>Iodine deficiency </li></ul></ul><ul><ul><li>Atrophy of thyroid </li></ul></ul><ul><ul><li>Surgery </li></ul></ul><ul><ul><li>Destruction of thyroid by I 131 </li></ul></ul>
  • 22. Hypothyroidism Severe Myxedema <ul><li>Characteristics </li></ul><ul><li>Growing puffiness & sogginess of the skin </li></ul><ul><li>Dry, waxy edema (non-pitting) </li></ul><ul><li>Abnormal deposits of mucin in the skin </li></ul><ul><li>Distinctive facial changes </li></ul>
  • 23. Hypothyroidism Severe <ul><li>Myxedema Coma </li></ul><ul><li>Met. Rate drops so low  life threatened </li></ul><ul><li>Temperature </li></ul><ul><ul><li>< 95 F </li></ul></ul><ul><li>Blood pressure </li></ul><ul><ul><li> </li></ul></ul><ul><li>Glucose </li></ul><ul><ul><li> </li></ul></ul><ul><li>Mental function </li></ul><ul><ul><li> </li></ul></ul>
  • 24. Hypothyroidism Severe <ul><li>Myxedema Coma </li></ul><ul><li>Death d/t… </li></ul><ul><ul><li>Respiratory Failure </li></ul></ul>
  • 25. Goiters <ul><li>Definition </li></ul><ul><li>Enlarged thyroid </li></ul><ul><li>Pathophysiology </li></ul>
  • 26. Review! <ul><li>What hormone causes the thyroid to grow? </li></ul><ul><ul><li>TSH </li></ul></ul><ul><li>What hormonal change causes goiters? </li></ul><ul><ul><li> TSH </li></ul></ul>
  • 27. Goiters <ul><li>Definition </li></ul><ul><li>Enlarged thyroid </li></ul><ul><li>Pathophysiology </li></ul><ul><li> TSH levels  goiters </li></ul><ul><li>Etiology </li></ul><ul><li> TH levels </li></ul><ul><li> Iodine </li></ul><ul><li>PG </li></ul>
  • 28. Goiters <ul><li>Endemic goiter </li></ul><ul><ul><li>Caused by environmental factors </li></ul></ul><ul><ul><ul><li> iodine </li></ul></ul></ul>
  • 29. Goiters <ul><li>Are goiters assoc. with </li></ul><ul><ul><li>Hyperthyroidism </li></ul></ul><ul><ul><ul><li>YES! </li></ul></ul></ul><ul><ul><li>Hypothyroidism </li></ul></ul><ul><ul><ul><li>YES! </li></ul></ul></ul><ul><ul><li>Euthyroid state </li></ul></ul><ul><ul><ul><li>YES! </li></ul></ul></ul><ul><li>All of the above </li></ul>
  • 30. Goiters <ul><li>Goitrogens </li></ul><ul><li>Suppress thyroid function </li></ul><ul><ul><li>Broccoli </li></ul></ul><ul><ul><li>Cauliflower </li></ul></ul><ul><ul><li>Cabbage </li></ul></ul><ul><ul><li>Turnips </li></ul></ul><ul><ul><li>Sulfonamide </li></ul></ul><ul><ul><li>Lithium </li></ul></ul><ul><ul><li>Salicylates </li></ul></ul>
  • 31. Goiters <ul><li>S&S </li></ul><ul><li>Enlarged thyroid </li></ul><ul><li>Complications </li></ul><ul><li>May interfere with </li></ul><ul><ul><li>Respiration </li></ul></ul><ul><ul><li>Swallowing </li></ul></ul>
  • 32. Goiters <ul><li>Nursing Management </li></ul><ul><li>Diet </li></ul><ul><ul><li>Limit goitrogens </li></ul></ul><ul><li>Assess </li></ul><ul><ul><li>Breathing </li></ul></ul><ul><ul><ul><li>Stridor </li></ul></ul></ul><ul><ul><li>Swallowing </li></ul></ul><ul><li>Palpate???? </li></ul><ul><ul><li>NO! </li></ul></ul>
  • 33. Cancer of the Thyroid gland <ul><li>Etiology </li></ul><ul><li>Rare </li></ul><ul><li>F>M </li></ul><ul><li>Thyroid hyperplasia </li></ul><ul><li>Radiation </li></ul><ul><li>Iodine deficiency </li></ul>
  • 34. Cancer of the Thyroid gland <ul><li>#1 S&S </li></ul><ul><ul><li>Nodule on thyroid </li></ul></ul><ul><ul><li>Hard </li></ul></ul><ul><ul><li>Painless </li></ul></ul>
  • 35. Cancer of the Thyroid gland <ul><li>S&S </li></ul><ul><li>Difficulty swallowing or breathing </li></ul><ul><li>Changes in voice </li></ul><ul><li>Lab values </li></ul><ul><ul><li>Normal TH levels </li></ul></ul>
  • 36. Cancer of the Thyroid gland <ul><li>Diagnostic Tests </li></ul><ul><li>Thyroid scan </li></ul><ul><ul><li>Shows “cold” spot </li></ul></ul><ul><ul><ul><li>Area that did not take up radioactive material </li></ul></ul></ul><ul><ul><ul><li>Indicates malignancy </li></ul></ul></ul><ul><li>Biopsy </li></ul><ul><ul><li>Confirms diagnosis </li></ul></ul>
  • 37. Cancer of the Thyroid gland <ul><li>Medical Management </li></ul><ul><li>Thyroidectomy </li></ul><ul><ul><li>Partial </li></ul></ul><ul><ul><li>Total </li></ul></ul><ul><li>Chemotherapy </li></ul>
  • 38. Cancer of the Thyroid gland <ul><li>Nursing Management- thyroidectomy </li></ul><ul><li>Pre-op </li></ul><ul><ul><li>Euthyroid state </li></ul></ul><ul><ul><li>Verify meds taken </li></ul></ul>
  • 39. Cancer of the Thyroid gland <ul><li>Nursing Management- thyroidectomy </li></ul><ul><li>Post-op </li></ul><ul><ul><li>Vital Signs </li></ul></ul><ul><ul><li> BP &  Pulse = </li></ul></ul><ul><ul><ul><li>Shock d/t hemorrhaging </li></ul></ul></ul><ul><ul><li> Pulse  fever  BP = </li></ul></ul><ul><ul><ul><li>Thyrotoxic crisis </li></ul></ul></ul>
  • 40. Cancer of the Thyroid gland <ul><li>Nursing Management- thyroidectomy </li></ul><ul><li>Post-op </li></ul><ul><ul><li>Check hemohaggin </li></ul></ul><ul><ul><ul><li>back of neck for pooling blood </li></ul></ul></ul><ul><ul><li>Check for S&S of dyspnea or resp distress </li></ul></ul><ul><ul><li>Check speech </li></ul></ul><ul><ul><li>Semi-fowlers position </li></ul></ul>
  • 41. Cancer of the Thyroid gland <ul><li>Nursing Management- thyroidectomy </li></ul><ul><li>Post-op </li></ul><ul><ul><li>Activity </li></ul></ul><ul><ul><ul><li>Support neck </li></ul></ul></ul><ul><ul><li>Monitor for Tetany </li></ul></ul><ul><ul><ul><li>Continuous tonic spasm </li></ul></ul></ul><ul><ul><li>Tracheostomy set at bed side </li></ul></ul><ul><ul><ul><li>Resp. obstruction </li></ul></ul></ul><ul><ul><li>Diet Changes (esp. if hyperthyroidism) </li></ul></ul><ul><li>Tetany </li></ul><ul><li>Tetanus </li></ul>
  • 42. Thyroidectomy Complications <ul><li>Thyrotoxic crisis </li></ul><ul><ul><li>D/t manipulation of thyroid during surgery  </li></ul></ul><ul><ul><li>release large amount of TH </li></ul></ul>
  • 43. Thyroidectomy Complications <ul><li>Tetany </li></ul><ul><li>D/T low Ca levels </li></ul><ul><li>Characterized by </li></ul><ul><ul><li>Fingers & perioral area tingling </li></ul></ul><ul><ul><li>Muscle spasm </li></ul></ul><ul><ul><li>Twitching </li></ul></ul><ul><ul><li>Cardiac Dysrhythmias </li></ul></ul><ul><li>Etiology </li></ul><ul><ul><li>D/t removal of parathyroid gland </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>IV Calcium gluconate </li></ul></ul><ul><ul><li>Breath into a paper bag  </li></ul></ul><ul><ul><li>mild acidosis  </li></ul></ul><ul><ul><li> Calcium in blood </li></ul></ul>

×