Thyroid Disorders: Hyper and Hypothyroidism Overview

Sep 29, 2024

SimpleNursing: Understanding Hyper and Hypothyroidism

Introduction

  • Nurse Mike from SimpleNursing.com introduces the topic of hyperthyroidism and hypothyroidism.
  • Encourages access to study guides and quizzes.

Basics of Thyroid Function

  • Thyroid Regulates: Energy and metabolism via hormones T3 and T4.
  • Pathophysiology: Hypothalamus releases TRH → Anterior pituitary releases TSH → Thyroid stimulated.
  • Key Hormones: T3, T4, and Calcitonin.
    • Calcitonin tones down calcium levels in the blood by increasing bone calcium.

Hyperthyroidism

  • Characteristics: High energy and metabolism.
  • Causes:
    • Graves' disease (autoimmune).
    • Excess iodine.
    • Over-medication in hypothyroidism treatment.
  • Symptoms:
    • High heart rate, BP, temperature.
    • Weight loss, hot/sweaty skin.
    • Diarrhea, high calorie burn.
    • Exophthalmos (bulging eyes) and goiter (swollen throat).
  • Management:
    • High-calorie diet, avoid high fiber, caffeine, spicy foods.
    • Medications: Methimazole, PTU, SSKI, Beta blockers.
    • Radioactive iodine uptake (RAIU) for destruction of thyroid.
    • Surgery (thyroidectomy) considerations.

Hypothyroidism

  • Characteristics: Low energy and metabolism.
  • Causes:
    • Hashimoto’s disease (autoimmune).
    • Low iodine intake.
    • Pituitary tumors, anti-thyroid treatments.
  • Symptoms:
    • Fatigue, weight gain, constipation.
    • Hair loss, depression, low libido.
    • Cold intolerance, dry skin.
  • Management:
    • Low-calorie diet, frequent rest periods.
    • Medication: Levothyroxine (Lifelong drug, taken on empty stomach).
    • Avoid narcotics, sedatives.

Diagnostic and Treatment Considerations

  • Diagnostic Focus: T3 and T4 levels; TSH will be opposite.
  • NCLEX Priorities:
    • Hyper: Monitor for thyroid storm (extreme high vitals).
    • Hypo: Myxedema coma (extreme low vitals).
  • Patient Education:
    • Hyperthyroidism: Reduce exposure post medication.
    • Hypothyroidism: Lifelong medication adherence.

NCLEX Tips

  • Hyperthyroidism: Monitor for agitation, confusion, thyroid storm risks.
  • Hypothyroidism: Avoid electric blankets, ensure medication consistency.
  • After Surgery:
    • Airway management (stridor, weak voice).
    • Monitor calcium levels (tingling, numbness).
    • Proper positioning to prevent complications.

Conclusion

  • Encouragement to take quizzes and review study materials.
  • Emphasis on understanding signs and symptoms for NCLEX and nursing practice.