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  2. DEFINATION Hypothyrodism :- It is condition charqtrised in sufficient release of thyroid hormone due to problem in the hypothalamus pituitary gland or thyroid gland it self result in slowing of all body process.
  3. Type of hypothyroidism  Primary hypothyroidism:- due to ds function of thyroid gland it self.  secondary hypothyroidism :- due to disorder of pituitary gland also caused by peripheral persistence to thyroid hormone .  Tertiary hypothyroidism:- Due to failure of hypothalamus to produce T.R.H
  4. RISK FACTOR Endemic gaiter occur in client living area that are iodine deficient in social and water.
  5. CAUSES  Congenital defect of the thyroid (cretinism).  Defective hormone synthesis .  Iodine deficiency (prenatal –postnatal).  Anti thyroid drugs .  Surgery and radiation therapy .  Chronic inflammatory daises of thyroid gland.
  6. Sing and Symptom  As metabolic slow the pt may experience weakness sleepiness , fatigue,slowness of speech and though feeling of cold , constipation ,slight to moderate weight gain ,oedema of larynx and medial ear may cause voice change (horsiness) .  Hearing loss (in sever cases).  Dry skin and coarse hair .  Puffy eye lids face and hand and swollen leg  In sever hypothyroidism un treated myxedema coma may occur.
  7. Diagnosis test  Thyroid function test .in primary thyrodism  Blood test (T.R.H, T.S.H, ).  T3, T4.check decrease.
  8. MEDICAL MANGEMENT  Synsithic thyroxin .  Other type of management supportive therapy.
  9. Complacation  Hyperthyrdism  comamyxedema  In sever hypothyroidism and myxedema coma management include maintaining the vital function (ABG)should be measure to determine use of assisted ventilation to compact hypoventilation.
  10. Complacation  Pulse ox meter help full monitoring oxygen saturation level.  Effects of thyroid hormone may be increase by try cyclic anti depressant .  Thyroid hormone may increase pharmacological effect of digitalis –anti coagulant and end mechanic.
  11. Nursing diagnosis  Activity intolerance related to fatigue and depressant Goal :- to increase participation in activity Implementation :- I. Promote independent in self car activity. II. Space activities to promote rest and exercise as tolerated.
  12. Nursing diagnosis I. Provide stimulation through alter thought process conversation and non stress full activities. II. Monitor pt response to increase activity.
  13.  Constipation related to deprest GIT function GOAL :- return to normal bowel function implementation :-  engorge fluied intake with in limits of fluid Restruction.  Provied food high in fibres.  instruct pt about food with high water content monitoring bowel function.
  14.  encourage mobility with in pt exercise to clearance.  engorge pt to use laxative medication as needed.  Hypothermia related to slowed metabolic rate. goal :- client will maintain normal body temperature. implementation :-  Provide extra layer of clothes or extra blanket  Avoid use of external heat sources e.g. Electric  Monitor pt body temperature and report.
  15.  Knowledge deficit about therapeutic regimen for life long thyroid replacement therapy. Goal :- knowledge and acceptance of the prescribe therapeutic regimen. Implementation:-  Explain for thyroid hormone replacement.  Describe effect of medication to the pt.  Explain the necessary for long term fallowup To pt and family.
  16.  Risk for complication( collaprotive problem) e.g. Maxyedema coma . Goal :- present of complication  Monitoring pt for increasing severity of sign and symptom of hypothyroidism and avoid use of hypnotic selective and analgesic agent.  Support if their is respiratory depression and failure.  Turn and re position pt at intervals.
  17. Hyperthyrodism
  18. DEFINATION hyperthyroidism :- It’s the condition represent the physiological response of the body to an excessive function activity of the thyroid gland.
  19. Pathophysiology Hyperthyroidism is characterized by lose of normal regulatory control thyroid hormone secretion. Hyper metabolism result with increase thempathatic (nerves system activity).
  20. causes Thyroiditis :- inflammation of thyroid gland abnormal stimulation of the thyroid gland by circulation immunoglobulin . the exact case is unknown but recently it though to be associated with thyroid stimulated immunoglobulin.  it may appear after and emotional shock stress or an infection.
  21. causes  though come case including thyroids and excessive in digitations of thyroid hormone. Graves’ Disease: stimulating autoantibodies.
  22. Sing &Symptom  Sweating and heat intolerance.  Weight loss inspect increase appetite.  Hart rate increase signs tachycardia.  Loss stool or diarrhoea are common.  Skin is warm and mist fine silky hair.  CNS :- nervousness , restlessness.
  23. Sing &Symptom  Pt insomnia.  Goiter.  Menstrual irregularities.  Pt exophthalmoses (bleeding eyes)& pain or diplopia.
  24. diagnosis Radio active iodine up take scan. Blood stimation of hormane. ECG.
  25. Complication  Hypothyroidism.  Tachycardia more than 130.  Temperature 38.5 above.  Disturbance of major system :- GIT system(weight loss and diarrhoea) Neorgical system coma. Cardio vascular system. Oedema , chest pain, dyspnoea and palpitation.
  26. Medical mangement  Anti thyroid drugs drug e.g. Methimalol.  Irradiation iodine.  Removal of mast of thyroids (thyroid resection).
  27. Nursing diagnosis 1- Alter nutrition less tan body require mint R/T execrated metabolic rate excessive appetite increase GIT activity. Goal :- improve nutritional status Implementation :-  Pt apetite may be satisfied by several well balance meal of smal size.  Food and fluid are selected to replase fluied  Loss though dirrhea .
  28. Nursing diagnosis  Reduce coffe cola and stop alcoholic colorie.  And high protein food are engorge.  PT weight and dietary intake record to monetar nutrition statis.
  29. Nursing diagnosis 2- in effective coping R/t Irritability and emotion instability. GOAL :- improve coping abilites Implementation :- the pt need reasurence Amotion reaction are result of disorder and With effective treatment thoesymption will be control.
  30. Nursing diagnosis  Family and friend needle re assurance that symptom are expected to dis appear with treatment.  It is important to ves calm unhurried approach with PT.  Stress ful experience are minimise the PT lsnet placed in room with very ill with to cative PT if hostitalive.  Relax activity are engorge.
  31. Nursing diagnosis 3/ Alter body temp related to sweating. Goal :- to maintain normal body temp Implementation :- The environment should be maintained at cool Comfortable and closing should be change as needed.
  32. Difference Between Hypo & Hyper thyroidism hypothyroidism  Fatigue.  Feeling cold.  Rapid weight gain.  Slow heart rate.  Slow Decreased. Sweating.  Constipation.  depression, moodiness. hyperthyroidism  Fatigue.  Feeling hot.  Rapid weight loss.  Increased or irregular heart rate.  Excessive sweating.  Diarrhea.  Anxiety, nervousness.
  33. Difference Between Hypo & Hyper thyroidism hypothyroidism  low blood pressure.  Dry skin and hair.  increased menstrual flow.  Facial swelling or other swelling. hyperthyroidism  high blood pressure.  skin thinning.  lack of menstrual period.  Insomnia.