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Causes
- decreased thyroid tissue
- decreased synthesis of thyroid hormone
- inadequate TSH
- WORLDWIDE: deficient iodine (table salt)
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Aging vs. hypothyroidism
look at chart
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Appearance
- coarse features
- edema
- tongue
- slow
- gain weight
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vs are ________
decreased
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Psychosocial
- depression
- lethargic
- apathetic
- social isolation
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Laboratory assessment
- opposite of hyper
- look at chart
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Interventions
- O2 supplement and saturation
- Prevent hypotension
- Monitor cognition
- Drugs
- Nutrion
- Education
- Safety
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Nutrition
decrease calories and increase bulk
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Drugs
- hormone replacement (synthroid)
- lifelong
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Education
- hormone replacement
- diet
- tx effects- look for signs and symtpoms of hyperthyroid from drug therapy
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Safety
- cognitive function- slow mentally
- Potential for myxedema coma
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myxedema coma
- Nonpitting edema, hoarseness, thick tongue
- life threatening
- symptoms escalate
- Unreated or undertreated hypothyroid
- decrease cardiac output
- End up with cardiac failure
- tissue and organ failure
- very high mortality rate
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Things to monitor during myxedema coma
- mental status
- vs, iand o, weight, temp, airway
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Drugs for myxedema
levothyroixine and corticosteroids
66-7
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triggers for myxedema coma
acute illness, surgery, chemo, thyroid meds, opiods
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3 types of Thyroiditis
- Acute
- Subacute (granulomatous)
- Chronic (hashimoto's disease- most common)
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Assessment with thyroiditis
- dysphagia
- painless thyroid enlargement
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Interventions thyroiditis
- drug therapy
- comfort
- education
- subtotal thyroidectomy
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Thyroid cancer types
- Papillary- most common, slow growing
- Follicular- age, invades, mets to bone and lung
- Medullary- age
- Anaplastic- rapid growing and aggressive, mets (radiation
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