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Largely related to elevated serum calcium

-elevated serum calcium levels

-decrease phosphorus

-muscle weakness and atrophy

-low back pain

-prolong PR

-shortened QT

-constipation, anorexia, and nausea/vomiting

-renal stones

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Fatigue, Lethargy, Intolerance to cold, constipation, hair loss, Dry Flaky Skin, Thick brittle fingernails, Weight Gain

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-Acute pain related to pressure in renal tubules secondary to development of calcium-based renal calculi

-high risk for injury: falls related to bone demineralization and calcium resorption

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Addison disease results from the destruction of the bilateral adrenal cortex, leading to decreased adrenocortical hormones, including cortisol, aldosterone, and androgens; autoimmune disease

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Thyroid Hormone Replacement-Levothyroxine

Nursing Actions:

Monitor for cardiovascular compromise, inform the client that fiber supplements, calcium, iron and antacids interfere with absorption

Client Education:

Tx begins slowly and the dosage will be increased every 2-3 weeks until the desired response is obtained, Monitor TSH levels, take medication on an empty stomach, monitor for and report manifestations of hyperthyroidism

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Fatigue

Lethargy

Muscle weakness

Low mood irritability

Loss of appetite and weight loss

Polyuria

Increased thirst

Craving for salty foods

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Diabetes Insipidus: treatable condition in which your body produces too much urine. Diabetes insipidus is mostly caused by an issue with how your body makes and uses antidiuretic hormone (ADH, or vasopressin)

Antidiuretic hormone: (ADH, or vasopressin) is a hormone that your hypothalamus makes and your pituitary gland stores and releases.

In most cases of diabetes insipidus, your hypothalamus isn’t making enough ADH, your pituitary gland isn’t releasing enough ADH or your kidneys aren’t properly using ADH. This causes frequent and excessive water loss through your urine.

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Needing to pee often, including through the night.

Passing large amounts of light-colored or clear urine each time you pee.

Feeling very thirsty and drinking liquids very often.

Dry skin

Dizziness

Nausea

Syncope

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Monitor for Cardiovascular changes

Monitor for chest pain

Monitor the client's weight

Monitor Vital Signs

Provide extra clothing and blankets for clients who have decreased cold tolerance

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Hyperparathyroidism is an abnormal regulation of parathyroid hormone secretion by calcium, resulting in hypersecretion of parathyroid hormone relative to the serum calcium concentration

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Examination of skin and mucous membrane for hyperpigmentation (hallmark sign)

Monitor for wasting of subcutaneous tissue

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Blood testing

sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). A blood test also can measure antibodies related to autoimmune Addison's disease.

ACTH stimulation Test

Insulin induced hypoglycemia Testing

Imaging test

CT scan of Adrenal Glands

MRI of pituitary gland

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Also known as Schwartz-Bartter syndrome

Results from an overproduction of ADH (vasopressin) secreted by the posterior lobe of the pituitary gland (neurohypophysis)

ADH increases the permeability of the renal distal tubule and collecting duct – leading to water reabsorption into the circulation. ECF volume expands –> Plasma osmolality declines, GFR increases, and sodium levels decline.

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-weak bones/bone or joint pain

-fatigue

-mental health issues (depression, anxiety, psychosis, irritability)

-loss of appetite, abdominal pain, N/V/D

-increased urination and frequency

-kidney stones

-sleeping problems

-headaches

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Hyperthyroidism is a Clinical syndrome that is caused by excessive circulating thyroid hormones. Primary hyperthyroidism is when thyroid-stimulating antibodies bind to then activate thyrotropin receptors that cause the thyroid to enlarge and continuously synthesize thyroid hormones.

Excess thyroid hormone exaggerates normal body functions.

Risk factors- female ages 30-5 0

Causes- Grave's disease, thyroiditis, toxic adenoma

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Blood TSH level: Decreased in Graves disease (can be elevated in secondary or tertiary Hyperthyroidism)

Free T4 index, T4 (total) T3: Elevated

Thyroid-stimulating immunoglobulin: Elvated in Graves disease and normal in other types of hyperthyroidism

Thyrotropin receptor antibodies: Elevated in Graves Dease

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Sepsis

Shock

Chronic Fatigue Syndrome

Infectious mononucleosis

Hypothyroidism

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Hormone replacement therapy for deficiencies

Corticosteriods

Hydrocortisone (Cortef),

prednisone (Rayos)

methylprednisolone (Medrol) to replace cortisol. These hormones are given on a schedule to act like the changes in cortisol levels the body goes through over 24 hours.

Fludrocortisone acetate to replace aldosterone

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Thyroid produces three hormones,

Thyroxine (T4)

Triiodothyronine (T3)

Thyrocalcitonin (Calcitonin)

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Increased body weight

Thirst

Dyspnea on exertion

Fatigue

Hyponatremia --> personality changes, hostility, sluggish deep tendon reflexes, N/V, diarrhea

Oliguria w/ dark yellow concentrated appearance and an increase in urine osmolarity

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endocrine disorder characterized by excessive adrenocorticotropic hormone (ACTH) production by the anterior pituitary, leading to the release of an excess of cortisol from the adrenal glands.

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Monitor BP for changes

hypotension

Monitor input/output

fluid and electrolyte balance

assess for weight changes

Monitor for hypoglycemia

Assist with ADL

Educated about condition

Regular check ups

Medical alert bracelet

Carry a glucocorticoid injection kit

Avoid food high in sugar and fats

Sick day rules - increase medication dose during periods of stress or illness

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High BP, rapid wt gain, rounded moon face, bone loss, purple stretch marks around the abdominal area, fatty lump on upper back, slow wound healing, easily bruised, acne and mood instability.

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Water deprivation testing

Blood work to test for antidiuretic hormone levels and glucose levels

Urinalysis to test for ketones and osmolarity

MRI to visualize the hypothalamus and pituitary gland.

Vitals

Intake and output

BUN creatinine

Weight

skin turgor

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For moon facies

excessive hair growth on the face, neck, chest , abdomen and thigh

weight gain- face, chest, and stretch marks

Body shape - buffalo hump

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PCOS or metabolic syndrome

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LABS:

T3 and T4: Decreased

TSH: Increased with primary hypothyroidism

Decreased or within the expected reference range in secondary Hypothyroidism

Blood Cholesterol: Increased

DIAGNOSTIC PROCEDURES

Thyroid Scan: Low uptake of the radioactive preparation

ECG: Sinus bradycardia and dysrhythmias

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Thionamides

Beta-adrenergic blockers

Iodine solutions

Radioactive iodine (ablation) therapy

Thyroidectomy

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what as the RN need to monitor for: high BP, weight gain, infection, same as S/S including BW checking ACHT, cortisol and other hormones, sugar levels, late-night salivary cortisol levels

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Diabetes Millitis

UTI

BPH

Urinary Incontinence

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Hypothyroidism occurs when there is a dysfunction of the thyroid gland causing there to be inadequate thyroid hormones present in circulation. The hormones affected are T₃ and T₄. A decrease in these hormones cause a decrease in metabolic rate of the body which leads to a variety of systemic changes. The primary causes of hypothyroidism include medications that reduce thyroid hormone output, thyroid procedures, thyroiditis, radiation therapy, deficiencies in iodine intake, and cellular damage of the tissue. The secondary case of hypothyroidism encompasses either the inadequate release of thyroid stimulating hormones from the pituitary or the thyroids inability to respond to such stimulating pituitary hormones. The tertiary case includes the failure of the hypothalamus to stimulate thyroid releasing hormone.

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1. Thin hair- fine, soft silky texture

2. Goiter

3. Bruit over thyroid

4. Weight loss

5. Increased appetite

6. Heat intolerance

7. Muscle weakness

8. Menstrual irregularities

9. Tachycardia

10. nervousness/ irritability

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The patient may appear lethargic or confused due to hyponatremia

Mild hypertension due to fluid retention and tachycardia as the body compensates

Possible mental status alteration, seizures, headaches, muscle cramps, and tremors due to hyponatremia

RAPID WEIGHT GAIN

LOW URINE OUTPUT

HIGH urine specific gravity

Cheyne-Stokes respirations

Distended neck veins, taut skin, and weight gain without edema

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Desmopressin or vasopressin

chlorpropamide

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Acute Kidney Injury/ Chronic Kidney Injury

Impaired renal function leads to an inability to excrete water

S/S: reduced urine output, fatigue, and swelling

Heart Failure

Reduced cardiac output causes decreased renal perfusion

S/S: Fatigue, Crackles

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Fluid Restriction is a first-line treatment to increase sodium levels (restrict to less than 1,000 ml per day)

Hypertonic Sodium Chloride IV fluid

Add oral salt tablets to patient's diet

Prescribe loop diuretics (Furosemide) to help excretion of fluid from kidneys

Prescribe vasopressin antagonists such as Tolvaptain and Conivaptan that block the action of ADH

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First priority: Restrict oral fluids (500 ml to 1000ml/day) to prevent hemodilution

To address thirst → mouth care, ice chips, lozenges, staggered water intake

Use 0.9% NaCl instead of water to flush enteral tubes, mix medications, or dilute feedings administered enterally

Monitor and maintain strict I&O; report oliguria

Monitor vital signs for increased BP, tachycardia, and hypothermia

Auscultate lung sounds for crackles (pulmonary edema)

Weigh the patient daily (report weight gain of 1kg)

Report headache, confusion, lethargy, seizures, coma

Maintain seizure precautions, especially for + altered mental status

Monitor for indications of heart failure (if + fluid overload → use loop diuretic)

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Importance of drinking water to prevent dehydration

Reduce the amount of salt and protein in diet

add more fruits and vegetables to prevent constipation

use alcohol free skin products to prevent drying out skin

provide skin and mouth care with soft brittle tooth brush

Monitor for dry cracked lips, weight loss, dizziness, and confusion for signs of dehydration and seek emergent medical attention.

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The nurse should monitor the client for any changes related to their cardiovascular health. Such changes can include low blood pressure, bradycardia, and dysrhythmias.  The nurse should also monitor the client for any signs of chest pain, abnormal respiratory findings, weight changes, changes in mental status, and new manifestations of edema. The nurse should also ensure that the patient has a consult with a dietitian, meticulous skin care, extra clothing and blankets, and stool softeners if needed. CNS depressants should be avoided and medications should be carefully managed as there is often altered rates of excretion in these clients. Furthermore, the nurse should educate the client about the side effects of treatment.

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Nursing indications & Patient education 

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Nursing indications & Patient education 

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Nursing

-The RN should know that radioiodine therapy is contraindicated in pregnant clients

-The RN should monitor manifestations of Hypothyroidism such as ( Edema, intolerance to cold, Bradycardia, increase in weight, and depression )

Education

- The effects of therapy might not be evident for 6 to 8 weeks.

-Continue taking antithyroid medication as directed

-Stay at least 1 m away from pregnant individuals, infants, or small children for the first week after tx. Limit contact to no more than 1 hr daily.

-Report incisional drainage, swelling, or redness which can indicate infection (post op )

-Report fever, increased restlessness, palpitations, or chest pain.

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1) Calcimimetics: cinacalcet (Sensipar): it mimics the action of calcium circulating in the blood, use to treat primary hyperparathyroidism

2) Hormone replacement therapy- helps maintain calcium level

3) Bisphosphonates: Prevent calcium loss from bones

Nursing Interventions:

Monitoring and managing electrolytes: Regularly check serum calcium & PTH levels.

Monitor for signs of bone demineralization or fractures.

Monitor for renal test & fluid status for nephrolithiasis and renal function

Patient Education:

Educate about disease management, lifestyle modification such as avoid drinking and smoking, medication adherence and avoid dehydration.

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General Appearance-  restlessness and agitation- noticeable weight loss

Skin/hair- skin can feel warm and smooth- fine brittle looking hair

Eyes - Patient can present with a fixed gaze- staring - Bulging eyes

Cardiovascular- Elevated heart rate

Musculoskeletal- patient can present as being shaky- fine tremors

GI- Increase bowel movements

Nervous- increased reflex during testing- anxiety

Thyroid- bruit hear on auscultation

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Depression, Alzheimer's, rheumatological diseases, menopause, premenstrual syndrome, and iron deficiency anemia can present with some of the similar symptoms found in that of hypothyroidism. However, the aforementioned assessment findings, labs, and other diagnostic tests help to confirm the differential diagnosis of hypothyroidism.

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19 Thyroid Memes ideas | memes, thyroid, hilarious

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Nov 8, 2020 - Thyroid memes... need I say more?. See more ideas about memes, thyroid, hilarious.

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Medication induced hyperthyroidism- amiodarone causing increase thyroid levels.

Grave’s disease (type of hyperthyroidism)

Anxiety disorders

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Treatments:

Surgery

Medications:

1) Calcimimetics: cinacalcet (Sensipar): it mimics the action of calcium circulating in the blood

2)  Hormone replacement therapy- helps maintain calcium level

3)  Bisphosphonates: Prevent calcium loss from bones

Nursing Interventions:

Monitor and manage electrolytes: serum calcium & PTH levels.

Dexa scan: Bone demineralization or fractures.

Monitor for renal test & fluid status for nephrolithiasis and renal function

Monitor heart for BP, MI & stroke

Patient Education:

Educate about lifestyle modification such as avoid drinking and smoking, medication adherence and avoid dehydration.