Lecture Notes: Hyperthyroidism vs. Hypothyroidism

Introduction

• Nurse Mike and SimpleNursing.com: Introduction to thyroid conditions.
• Resources: Mention of quizzes and study guides.

Thyroid Function Overview

• Thyroid Gland: Regulates energy and metabolism.
• Thyroid Hormones: T3, T4 (active hormones), and Calcitonin (tones down calcium in the blood).
• Iodine: Essential for production of T3 and T4.

Hyperthyroidism

• Also known as Graves' Disease ("Gains Disease").
• Characteristics: High energy, high metabolism.
• Causes:
  • Autoimmune response (Graves' Disease).
  • Excessive iodine intake.
  • Overmedication when treating hypothyroidism.
• Diagnostic Tests:
  • Focus on T3 and T4 levels, not TSH.
  • T3 and T4 high indicates hyperthyroid state.
• Signs and Symptoms:
  • Hyperactivity, agitation, and restlessness.
  • High temperature, heart rate (tachycardia), and blood pressure.
  • Weight loss, heat intolerance, and diarrhea.
  • Characteristic signs: Exophthalmos (grape eyes) and Goiter (swollen throat).
• Diet and Restrictions:
  • High-calorie, protein, and carbohydrate intake.
  • Avoid caffeine, spicy foods, and high fiber.

Hypothyroidism

• Also known as Hashimoto's Disease.
• Characteristics: Low and slow energy and metabolism.
• Causes:
  • Autoimmune response (Hashimoto's Disease).
  • Low dietary iodine.
  • Pituitary tumors or thyroidectomy.
• Diagnostic Tests:
  • Focus on T3 and T4 levels; low T3 and T4 indicate hypothyroid state.
• Signs and Symptoms:
  • Fatigue, weight gain, cold intolerance, constipation, and dry skin.
  • Memory issues, depression, low libido, and irregular menstruation.
  • Risk of Myxedema Coma (extreme low state).
• Diet and Care:
  • Low-calorie diet, frequent rest periods.

Pharmacology

Hypothyroidism

• Levothyroxine:
  • Main treatment, lifelong medication.
  • Slow onset; takes 3-4 weeks for effects.
  • Empty stomach, morning intake.
  • Pregnancy safe.
  • No abrupt cessation to avoid Myxedema Coma.

Hyperthyroidism

• Methimazole and PTU:
  • Methimazole not safe for pregnancy; PTU is safe.
  • PTU can cause fever and sore throat.
• Potassium Iodide (SSKI):
  • Shrinks the thyroid before surgery.
  • Stains teeth; use a straw.
• Beta Blockers:
  • Used to manage symptoms by lowering heart rate and BP.
• Radioactive Iodine Uptake (RAIU):
  • Destroys thyroid in one dose; requires isolation due to radioactivity.

Surgical Treatment (Thyroidectomy)

• Risks and Monitoring:
  • Airway management (laryngospasms, stridor).
  • Monitor for thyroid storm.
  • Calcium monitoring due to risk of hypocalcemia.
• Positioning: Neutral head position; avoid flexion/extension of the neck.

NCLEX Tips

• Focus on T3, T4 levels for initial diagnosis.
• Monitor extreme symptoms related to heart rate, BP, and temperature.
• Understand dietary and medication management for both conditions.
• Prioritize airway, breathing, and circulation for thyroidectomy patients.

Conclusion

• Reminder to utilize resources and engage with SimpleNursing content for further learning.

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• Note: These notes cover the key points and highlights of the lecture for ease of review and study.