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Prepared By:Group 2

Thyroid Gland

• Hyperthyroidism
(Thyrotoxicosis)

• Hypothyroidism
(Myxedema)
Hyperthyroidism

•Definition
Excessive delivery of
thyroid hormone to
peripheral tissue
Causes
Autoimmune reaction(Grave disease)

Excess secretion of TSH from


pituitary gland

Neoplasm (toxic multinodular goiter)


Thyroiditis

Excessive intake of thyroid


medication
Clinical manifestation

• Metabolism
• Cardiovascular
• Gastrointestinal
• Neuromuscular
• Other
Treatment

• Medication
• Radioactive iodine therapy
• Surgery
Pre-op care

• Ensure pt know about the


procedure
• Consent sign
• Skin prep
• Nbm
• Medication
Post-op care

• Airway
• Haemorrage
• Hypocalcemia
Hypothyroidism

•Definition
Thyroid gland produce
insufficient amount of
thyroid hormone
Clinical manifestation

• Metabolism
• Cardiovascular
• Gastrointestinal
• Neurovascular
• Other
Causes
• Primary
Defect in thyroid gland

Congenital defect
Post treatment of hyperthyroidism

Thyroiditis

Iodine deficiency
Cont….

• Secondary

Deficiency in TSH(pituitary gland

Peripheral resistance to thyroid


hormones
Diagnostic test
• Serum thyroid
antibodies(TA):antibodies in Grave
disease
• TSH test:from pituitary suppressed
with primary hyperthyroidism
• T3&T4:elevated for diagnosis of
hyperthyroidism,thyroiditis
• T3 uptake test:elevated for
thyroidism
• RAI uptake test
• Thyroid suppression test
Treatment

• Medication
• Surgery
Nursing diagnosis

• Risk for decreased cardiac


output
Nursing intervention

• Monitor vital sign


• Assess for peripheral to
edema,jugular vein distention
and increased activity
intolerance
• Encourage to balance activity
Graves disease
(hyperthyroidism)
• Most common cause of
hyperthyroidism
• Antibody against TSH receptor
site
• Unknown,but hereditary link
• More common in females aged
20-40
Sign and symptom

• Sign of hypertyroidism plus


• Enlarged thyroid gland(goiter)
• protopsis causing blurred
vission,diplopia,lacrimation,pho
tophopia
• Exophthalmos causing corneal
dryness,irritation,ulceration
• Changes in menstruation
Toxic multinodular goiter

• Nodules in thyroid tissue


secrete excessive thyroid
hormone
• Usually female in 60-70’s,has
had goiter for a number of
years
thyroiditis

• Viral infection of thyroid


• May become chronic and lead
to hypothyroidism
Thyroid crisis(thyroid storm)
• Extream state of hyperthyroidism:rare
now
• Occur with untreated hyperthyroidism or
hyperthyroid person with stressor like
infection
• Life threatening condition with excess
metabolic symptoms such as temperature
elevation to 102-
106,hypertention,tachycardia,and
aggtation advancing to
seizure,psychosis,delirium
• Treatment includes reducing thyroid
secreation,stabilizing cardiovascular
system and managing respiratory distress
Hashimoto’s thyroiditis
(hypothyroidism)
Autoimmune disorder
Antibodies produced against
thyroid tissue
Myxedematous coma
• Life-threatening complication of
long-standing and untreated
hypothyroidism
• Hyponatremia,hypoglycemia,acidos
is
• Precipitated by stressors,failure to
take thyroid replacement meds
• Treatment includes restoring
balance throughout systems and
increasing thyroid hormone levels
Group member
• Sun • Taufiq

• Yana • Thilaga

• Linda • Nat

• Aemiey • Achik

• Nisha