Hyperthyroidism

Grave's Disease

Grave's= most common cause of hyperthyroidism

10X more common in women

Autoimmune

Have all CMs of hyperthyroidism PLUS:

Neuro - eyelid retraction, eye lag, globe lag, pretibial myxedema, exopthalmos

Hyperthyroidism

Assessment:

• Hallmark sign = HEAT INTOLERANCE
• Tests - increased everything, but LOW TSH in pt with Grave's Disease

Hyperthyroidism

Interventions

• Monitor for complications = THYROID STORM
• Uncontrolled HTN and tachycardia
• High fever - report increase of even 1 degree
• Can be triggered by stressor

Hyperthyroidism

Treatment:

• Lithium - inhibits TH release
• Surgery -incision just above clavicle
• Monitor for hypocalcemia - tetany, stridor, hemorrhage, thyroid storm

Hypothyroidism

Myxedema

• Cellular energy is decreased so sugar and metabolites build up in cells
• Buildup of mucus and water
• Forms cellular edema and changes organ texture
• Nonpitting edema everywhere
• Risk of myxedema coma:
• Heart muscle becomes flabby and chamber size increases, decreasing CO
• Decreased perfusion + slow cell metabolism = tissue and organ failure
• Mortality rate = HIGH!
• Homeless and elderly at risk because can't get warm enough

Hypothyroidism

CMs:

Hypothyroidism

Interventions:

• LIfelong thyroid hormone replacement therapy
• Synthroid - low dose, gradually increased
• Given in mcg, NOT MG

• Thyroiditis
• Thyroid CA - initial manifestation is a single, painless lump or nodule in thyroid