<h3><strong>Overview</strong></h3>
<ol style="list-style-type: upper-roman;">
<li>Hyperthermia
<ol style="list-style-type: upper-alpha;">
<li>Temperature is too high</li>
<li>Needs emergent treatment</li>
</ol>
</li>
</ol>
<h3><strong>Nursing Points</strong></h3>
<h4>General</h4>
<ol style="list-style-type: upper-roman;">
<li>Temperature too high
<ol style="list-style-type: upper-alpha;">
<li>Regulatory responses cannot keep up</li>
<li>Homeostasis not maintained -&gt; SIRS</li>
<li>Cellular destruction</li>
</ol>
</li>
<li> Causes
<ol style="list-style-type: upper-alpha;">
<li>Excessive heat exposure</li>
<li>Volume depletion</li>
<li>Exertional</li>
<li>Drug-induced</li>
</ol>
</li>
<li>Types
<ol style="list-style-type: upper-alpha;">
<li>Heat exhaustion
<ol>
<li>Sweating profusely</li>
<li>Fast HR</li>
<li>Weak pulse</li>
</ol>
</li>
<li>Heat stroke (&gt;104 degrees F)
<ol>
<li>Hot, dry skin</li>
<li>Elevated heart rate</li>
<li>Low blood pressure</li>
<li>Multisystem failure</li>
</ol>
</li>
<li>Malignant hyperthermia
<ol>
<li>Body reacts to anesthetic drug</li>
<li>Calcium ions are released from muscle cells</li>
<li>Muscle fibers contract causing excessive heat</li>
<li>Genetically susceptible</li>
</ol>
</li>
<li>Neuroleptic malignant syndrome
<ol>
<li>Body reacts to neuroleptic or antipsychotic drug</li>
<li>Disrupts hypothalamus (body temperature control center)</li>
<li>Temperature rises</li>
</ol>
</li>
</ol>
</li>
<li>Complications
<ol style="list-style-type: upper-alpha;">
<li>Temperature 104 or greater = life threatening</li>
<li>Permanent neurological damage</li>
<li>Organ system failure -&gt; MODS</li>
<li>Death</li>
</ol>
</li>
</ol>
<h4>Assessment</h4>
<ol style="list-style-type: upper-roman;">
<li>Presentation
<ol style="list-style-type: upper-alpha;">
<li>Fever</li>
<li>Sweaty or dry</li>
<li>Low blood pressure</li>
<li>Confusion</li>
<li>Seizures</li>
</ol>
</li>
</ol>
<h4>Therapeutic Management</h4>
<ol style="list-style-type: upper-roman;">
<li>Water</li>
<li>Cool room (passive)</li>
<li>Cool wet towel/blanket, ice packs (active)</li>
<li>Doctor order
<ol style="list-style-type: upper-alpha;">
<li>IV fluids</li>
<li>Antipyretics likely will not work (hypothalamus is overworked)</li>
<li>Iced saline gastric lavage (severe cases)</li>
</ol>
</li>
</ol>
<h4>Nursing Concepts</h4>
<ol style="list-style-type: upper-roman;">
<li>Thermoregulation
<ol style="list-style-type: upper-alpha;">
<li>Severly high body temperatures</li>
<li>Hypothalamus dysfunction</li>
</ol>
</li>
<li>Fluid &amp; Electrolyte Balance
<ol style="list-style-type: upper-alpha;">
<li>Need fast hydration -&gt; keep organs perfused</li>
</ol>
</li>
<li>Intracranial regulation
<ol style="list-style-type: upper-alpha;">
<li>High fever causes neurologic dysfunction</li>
</ol>
</li>
</ol>
<h3><strong>Patient Education</strong></h3>
<ol style="list-style-type: upper-roman;">
<li>Stay hydrated</li>
<li>Dress for the heat</li>
<li>Rest as needed</li>
</ol>


Med-Surg | Metabolic / Endocrine

03-05-hyperthermia-thermoregulation

03.05 Hyperthermia (Thermoregulation)

<h3><strong>Overview</strong></h3>
<p>Pathophysiology: This is caused by an autoimmune disorder that results in a deficiency of the thyroid hormone and the gland is unable to make sufficient amounts of the thyroid hormone.</p>
<ol style="list-style-type: upper-roman;">
<li>Hashimoto&#8217;s thyroiditis
<ol style="list-style-type: upper-alpha;">
<li>Autoimmune</li>
<li>Thyroid destruction &#8211;&gt; hypothyroidism</li>
</ol>
</li>
</ol>
<h3><strong>Nursing Points</strong></h3>
<h4>General</h4>
<ol style="list-style-type: upper-roman;">
<li>Autoimmune disorder
<ol style="list-style-type: upper-alpha;">
<li>Antibodies attack thyroid &#8211;&gt; injury</li>
<li>Thyroid hormones decrease</li>
<li>Result = hypothyroidism</li>
<li>Purpose of thyroid hormones
<ol>
<li>Energy</li>
<li>Warmth</li>
<li>Proper organ function</li>
</ol>
</li>
</ol>
</li>
<li>Diagnosed by lab values
<ol style="list-style-type: upper-alpha;">
<li>Elevated anti-thyroid peroxidase (TPO)&#8211;&gt; antibodies against thyroid</li>
<li>Elevated thyroid stimulating hormone (TSH) &#8211;&gt; high levels overcompensating
<ol>
<li>Made in brain, tells thyroid to release hormones</li>
<li>Normal usually 0.4-5.0 mU/L</li>
</ol>
</li>
<li>Thyroid hormones
<ol>
<li>Low T3 (nomal 80-180 ng/dL)</li>
<li>Low T4 (normal 4.6-12 ug/dL)</li>
</ol>
</li>
</ol>
</li>
<li>Autoimmune response triggered by&#8230;
<ol style="list-style-type: upper-alpha;">
<li>Genes</li>
<li>Virus/Infection</li>
<li>Drugs</li>
</ol>
</li>
</ol>
<h4>Assessment</h4>
<ol style="list-style-type: upper-roman;">
<li>Presentation
<ol style="list-style-type: upper-alpha;">
<li>Enlarged thyroid (goiter)</li>
<li>Fatigue</li>
<li>Coarse, dry skin</li>
<li>Weight gain</li>
<li>Sensitive to cold</li>
</ol>
</li>
<li>May not have symptoms</li>
</ol>
<h4>Therapeutic Management</h4>
<ol style="list-style-type: upper-roman;">
<li>Monitor
<ol style="list-style-type: upper-alpha;">
<li>TSH levels</li>
<li>Thyroid ultrasound &#8211;&gt; visualize thyroid</li>
</ol>
</li>
<li>Give levothyroxine &#8211;&gt; increase thyroid hormone release</li>
</ol>
<h4>Nursing Concepts</h4>
<ol style="list-style-type: upper-roman;">
<li>Hormone regulation &#8211;&gt; Immune system attack on thyroid results in decreased thyroid hormones and TSH</li>
<li>Lab values &#8211;&gt; Diagnosed by levels of TSH, T3, T4, TPO</li>
<li>Pharmacology &#8211;&gt; Treated with daily levothyroxine (synthetic hormone)</li>
</ol>
<h3><strong>Patient Education</strong></h3>
<ol style="list-style-type: upper-roman;">
<li>Follow up with labs</li>
<li>Continue physical activity</li>
<li>Take medication every day</li>
</ol>


01-08-nursing-care-and-pathophysiology-for-hashimotos-thyroiditis

01.08 Nursing Care and Pathophysiology for Hashimoto&rsquo;s Thyroiditis

<p><strong>Pathophysiology: </strong>There is a reduction in thyroid hormone secretion. This is caused by an autoimmune disorder attacking the thyroid and causing this reduction.</p>
<p>Overview</p>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Hyposecretion of thyroid hormone</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Results in a decreased metabolic rate</span></li>
</ol>
<h3><strong>Nursing Points</strong></h3>
<h4><span style="font-weight: 400;">General</span></h4>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Causes</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Hashimoto’s Thyroiditis</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Iodine Deficiency</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Thyroidectomy</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Myxedema Coma</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Acute Exacerbation</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Life-threatening state of decreased thyroid production</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Caused by acute illness, rapid cessation of medication, hypothermia</span></li>
</ol>
</li>
</ol>
<h4><span style="font-weight: 400;">Assessment</span></h4>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Hypometabolic state</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Goiter &#8211; enlarged thyroid due to iodine deficiency</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">↓ T3, T4, Free T4 hormones</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">↑ TSH levels</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Cardiovascular</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Bradycardia, hypotension</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Anemia</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Gastrointestinal</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Constipation</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Neurological</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Lethargy, fatigue, weakness</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Muscle aches</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Paresthesias</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Integumentary</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Dry skin</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Loss of body hair</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Metabolic</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Cold intolerance</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Anorexia</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Weight gain</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Edema</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Hypoglycemia</span></li>
</ol>
</li>
</ol>
<h4><span style="font-weight: 400;">Therapeutic Management</span></h4>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Medication Therapy</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Levothyroxine (Synthroid)</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Monitor &#8211; possible overdose</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Cardiac Monitoring</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Maintain open airway, especially with goiter</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Have tracheotomy supplies available</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">IV fluids to support hemodynamics</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Administer glucose/dextrose as needed</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Encourage nutrition intake</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Assess thyroid hormone levels</span></li>
</ol>
<h4><span style="font-weight: 400;">Nursing Concepts</span></h4>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Hormone Regulation</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Administer medications (levothyroxine)</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Monitor hormone levels (T3, T4, Free T4, TSH)</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Monitor for s/s Myxedema Coma</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Thermoregulation</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Keep warm</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Monitor temperature</span></li>
</ol>
</li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Nutrition</span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Ensure adequate nutritional intake</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Daily weights</span></li>
</ol>
</li>
</ol>
<h3><strong>Patient Education</strong></h3>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Do not stop taking medications without discussing with your provider</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Smoking Cessation</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Routine testing of TSH levels</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">s/s to report to provider </span>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">Could experience hyperthyroid if overdosing medications</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Myxedema coma</span></li>
</ol>
</li>
</ol>
<div style="margin-top: 20px; margin-bottom: 20px; width: 100%;background:white;border-radius:4px;padding:20px">
    <center>
        <span>Want to learn more?<br>View a suggested lesson</span><h4 style="margin: 10px;"><a href="https://admin.nursing.com/lesson/nursing-mnemonics-moms-so-tired/" style="text-decoration:none;">Symptoms of Hypothyroidism Nursing Mnemonic (MOM&#8217;S SO TIRED)</a></h4><h4 style="margin: 10px;"><a href="https://admin.nursing.com/lesson/nursing-care-plan-for-hypothyroidism/" style="text-decoration:none;">Nursing Care Plan (NCP) for Hypothyroidism</a></h4></center>
  </div>


hypothyroidism

Nursing Care and Pathophysiology for Hypothyroidism

<h3><span style="font-weight: 400;">Generic Name</span></h3>
<p>Levothyroxine</p>
<h3><span style="font-weight: 400;">Trade Name</span></h3>
<p>Levothroid</p>
<h4>Indication</h4>
<p>Thyroid hormone replacement in hypothyroidism</p>
<h4>Action</h4>
<p>Replaces thyroid hormone, increasing metabolism, promotes gluconeogenesis,<br />
stimulates protein synthesis, restores normal hormone balance and suppresses<br />
thyroid cancer</p>
<h4>Therapeutic Class</h4>
<p>Hormone</p>
<h4>Pharmacologic Class</h4>
<p>Thyroid preparations</p>
<h4>Nursing Considerations</h4>
<p>• Assess pulse and monitor for tachyarrhythmias and chest pain<br />
• Monitor TSH levels<br />
• Overdose is presented as hyperthyroidism<br />
• Start with low doses and increase as indicated<br />
• Therapy is lifelong<br />
• Take directly after breastfeeding<br />
• Increases the effects of warfarin</p>


18.05 Levothyroxine (Synthroid)

Included In This Lesson

Outline

Generic Name

Trade Name

Indication

Action

Therapeutic Class

Pharmacologic Class

Nursing Considerations

View the FULL Outline

About Us

Trusted Learning Hub

Most Popular Lessons

From the Blog