1. DISORDERS OF THYROID GLAND
BY: Mr.Ganesh V. Naik
II year MSc(N)
Pediatric Dept
SDM Institute of
Nursing Science’s
Dharawad
2. THYROID GLAND
It is located anteriorly in the neck below the cricoid
cartilage
The thyroid gland consist of two lobes, joined by a
thin band called the isthmus
The thyroid secretes two hormones
Tri-iodothyronine(T3)
Thyroxine(T4)
o Thyroid hormones are essential for normal growth
a CNS and metabolism of proteins, carbohydrates
and fats.
3.
4. CONT..
Hypothalamus secretes Thyrotropin releasing
hormone (TRH).
TRH stimulates Anterior pituitary to secrete Thyroid
stimulating Hormone(TSH)
TSH stimulates the thyroid gland to release T3 and
T4 Hormone.
6. INTRODUCTION
It is a condition of thyroid hormone deficiency
present at birth.
Approximately 1 in 400 newborn infants has sever
deficiency of thyroid hormone
If left untreated after birth, sever congenital
hypothyroidism can lead to growth failure, a
condition known as ‘Cretinism’
10. PATHOPHYSIOLOGY
Congenital hypothyroidism is most commonly
caused by developmental defect of thyroid gland
At 8th week of gestation, the thyroid gland normally
occupies its permanent anatomic site and at term it
reaches maximum functioning
Neonatal thyroid functioning is almost completelly
independent from that of mother
11. CONT…
Hypothyroid fetus does not get maternal thyroid
hormones to meet its metabolic requirement
The placenta doesnot allow passage of maternal
thyroid hormones
As result baby of mother is born with
hypothyroidism and fetal goitre
12. CLINICAL FEATURES
The clinical features appears first few weeks or
months of life
Onset is gradual
Patent fontanale and widely opened cranial sutures
Prolonged physiologic jaundice due to delayed
maturation of glucoronide conjugation
Birth weight is more than average
Babies are dull, flaccid
Pallor due to anemia
Feeding difficulties
Constipation
13. CONT…
Signs:
Skin
• Yellow discoloration
• Skin is dry and cold
Head and face
• Puffy face
• Swollen eyelids
• Open mouth with large protruding tongue
• Course brittle hair
• Neck is short
• Voice is hoarse
14. CONT…
Trunk and extremities
• Retarded skeletal development and maturation
• Short stature
• Hands are broad and fingers are short
• Protruding abdomen
Vital signs
-Temperature is subnormal(decreased metabolic rate)
-Pulse is slow
-Dyspnea
17. DIAGNOSTIC EVALUATION
History collection
Physical examination
Thyroid test :Serum T3 and T4 are low
Serum TSH and TRH are increased
Thyroid scan done to detect structural abnormality
of gland
18. MANAGEMENT
Medical Management
Goal:
-To maintain circulating serum T3 and T4 level in
normal range and normalize the elevated TSH
level.
-Treatment :
Daily dose of Thyroxin available
• Synthetic sodium levothyroxine for neonates the
dosage is 10-15mg/kg/day
19. NURSING DIAGNOSIS
Activity intolerence related to fatigue
Constipation related to depressed GI function
Hypothermia related to slowed metabolic rate
Knowledge deficiet related to disease condition