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Terms in this set (115)

1. Caused by excess of corticosteroids like Prednisone
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2.. Subjective
I. Malaise
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ii. Weight gain or Anorexia
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iii. Polyuria
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iv. Delayed wound healing
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v. Easy bruising
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vi. Sleep disturbances (insomnia)
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vii. Headache
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viii. Back, joint, bone, and rib pain
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ix. Poor concentration and memory
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x. Amenorrhea
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xi. Impotence, decreased libido
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xii. Mood disturbances
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xiii.Psychosis
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3. Objective
I. Thinning of hair
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ii. Friable skin
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iii. Acne
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iv. Petechiae
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v. Hyper-pigmentation, striae
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vi. Edema
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vii. Hypertension
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viii. Muscle wasting
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ix. Thin extremities
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x. Gynecomastia, testicular atrophy
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xi. Low potassium level
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xii. Elevated glucose level
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xiii. Elevated cholesterol
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xiv. Abnormal ACTH levels
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xv. Osteoporosis
a. Related to effect of thyroid hormone excess
I. ↑ Metabolism
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ii. ↑ Tissue sensitivity to stimulation by sympathetic nervous system
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b. Goiter (Inspection and Auscultation: bruits)
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c. Ophthalmopathy (Abnormal eye appearance or function)
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d. Exophthalmos (Bulging eyes) -Increased fat deposits and fluid, Eyeballs forced outward
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e. Intolerance to heat
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f. Finger clubbing
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g. Fine, straight hair
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h. Increased irritability
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I. Tachycaria
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j. Increased systolic BP
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k. Dyspnea on exertion
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l. Weight loss
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m. Muscle wasting
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n. Localized edema
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o. Menstrual changes (amenorrhea)
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p. Increased diarrhea
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q. Tremors
1. Administer medications to achieve euthyroidism
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2. Administer iodine to ↓ vascularity
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3. Assess for signs of iodine toxicity
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4. Patient teaching
a. Comfort and safety measures
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b. Leg exercises, head support, neck ROM
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c. Routine postoperative care
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5. Monitor for complications
a. Hypocalcemia
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b. Hemorrhage
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c. Laryngeal nerve damage
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d. Thyrotoxic crisis
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e. Infection
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6. Maintain patent airway (Oxygen, suction equipment, tracheostomy tray in patient's room!!, Monitor for laryngeal stridor, IV calcium readily available)
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7. Assess every 2 hours during first 24 hours for signs of hemorrhage or tracheal compression
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8. Semi-Fowler's position
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9. Support head with pillows
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10. Avoid neck flexion and tension on suture line
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11. Monitor vital signs and calcium levels
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12. Signs of hypocalcemia
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13. Analgesics
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14. Ambulation
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15. Psychosocial support
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The numbers are all of the nursing interventions for preoperative care
2. Most outpatient therapy
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3. Myxedema coma necessitates acute care
a. Mechanical respiratory support
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b. Cardiac monitoring
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c. IV thyroid hormone replacement
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d. Monitoring of core temperature
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4. Acute Care
a. Skin care
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b. Vital signs, weight, IandO, edema
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c. Cardiovascular response to hormone
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d. Energy level
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e. Mental alertness
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5. Patient teaching
a. Written instructions important
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b. Need for lifelong therapy
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c. Thyroid medicine in morning on empty stomach
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d. Side effects of medication
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e. Signs and symptoms of hypothyroidism and hyperthyroidism
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f. Regular follow-up care
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g. Do not switch brands - Medication interactions
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h. Comfortable, warm environment
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I. Measures to prevent skin breakdown
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j. Avoid sedatives or use lowest dose possible
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k. Measures to minimize constipation
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l. Relapses occur if treatment is interrupted
v. Acute Care
1. Frequent assessment necessary
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2. Correct fluid and electrolyte imbalance (Assess vital signs and neurologic status, Daily weight, and Accurate I and O)
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3. Obtain complete medication history
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4. Watch for signs of Cushing syndrome
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5. Guard against infection
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6. Assist with daily hygiene
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7. Protect from extremes (Light, Noise, and Temperature)
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vi. Patient teaching
1. Dosing
a. Glucocorticoids in divided doses
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b. Mineralocorticoids once in the morning
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c. Reflects normal circadian rhythm
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d. Decreases side effects of corticosteroids
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2. Need to increase corticosteroids during times of stress
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3. Carry identification and wear medical ID bracelet
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4. Emergency kit
a. How to administer IM hydrocortisone
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b. Written instructions