Testing For Flammability

• Rest

• Balanced nutrition

• Blocking the synthesis of thyroid hormone with anti thyroid drugs

• Surgery: total or near total thyroidectomy

• Destruction of the thyroid by radioactive

iodine (radio-iodine ablation)

Thyroiditis:

• Inflammation of the thyroid

• S/S: puffy eyes, anxiety, water retention in the GIT, fatigue, heat, excess sweating, weight loss etc.

• Causes: bacteria, virus, certain medication, autoimmune disease

• Types: hasimoto and silent thyroiditis

• Hasimoto: this is an autoimmune condition caused by anti thyroid antibodies. Most common form of thyroiditis band occurs in more women then men

• Silent: caused by anti thyroid antibodies and also

common in women than men.

…..

• Treatment; Radioactive therapy, steroids,

thyroid hormones, antibiotics e.g. ampicillin, penicillin

• Nursing management

• Adequate rest

• Increase fluid intake

• Physiological support

• Pulmonary exercise

Hashimoto’s disease

• It is an autoimmune disease disorder that can cause hypothyroidism or under active thyroid.

• The disease occur 8 times more in women than in men.

Although the disease may occur in teens or young women, it more often appears in ages 40 and 60.

• The disease can develop if you have autoimmune disorder conditions like

• 1.Addisons disease, a hormonal disorder.

• 2.Autoimmune hepatitis, a disease in which the immune system attacks the liver.

• 3.Celiac disease, a digestive disorder.

• 4.Lupus,a chronic or long term disorder that can affect many parts of your body.

….

• 5.Rheumatoid arthritis is a disorder that affects the joint and sometimes other body system.

• 6.Type 1 diabetes, a disease that occurs when your blood sugar is high.

Symptoms of Hashimoto’s disease

• 1.Enlarged thyroid gland (goitre)

• 2.Depression

• 3.Memory problems

• 4.Slowed heart rate

Causes of Hashimoto’s disease

• 1.Gene: People who get Hashimoto often have familiar members who have thyroid disease or other autoimmune disease.

• 2.Excessive iodine: Too much iodine, required by your body to make thyroid hormones, may trigger thyroid disease in susceptible people.

• 3.Radiation exposure: Increased cases of thyroid disease has been reported in people exposed to radiation.

• Pathophysiology

• The development of the disease is caused by

autoimmune origin with lymphocyte infiltration and fibrosis as typical features. The current diagnosis is based on clinical symptoms correlating with

laboratory results in elevated TSH with normal to low thyroxin levels.

• Nursing care and Management

• 1. Assess the patient.

• 2. Restore normal metabolic state by replacing the missing hormones.

• 3. Pharmacologic therapy.

Jane is not fond of eating sea food. She has been living in the city all her life and has grown accustomed to fast foods. At 34, she started noticing a growing lump in her neck area . She

consulted her physician and her physician told her that her low iodine levels had led to goitre ,and this may further progress to hypothyroidism.

• JANE’S NURSING CARE PLAN

Diagnosis Nursing

objective Nursing

intervention Scientific

rationel Evaluation Pain related to

surgical procedure evidenced by patient’s verbalization

Patient will verbalize less pain within 30 minutes to 1 hour of nursing

intervention

i)Assess pain level

ii)establish nurse patient

relationship iii) Give diversional therapy iv) Give Analgesics

i) To obtain base line data ii) To make patient feel comfortable iii) To distract patient from pain

iv) To stop pain

Patient

verbalized less pain within 40 minutes of nursing intervention

Risk for imbalance nutrition: less than body requirement related to medical condition.

Patient will show stable weight with no sign of malnutrition

i) monitor daily food intake ii) Encourage patient to eat and increase the

number of meals and snacks

iii) Provide a balanced diet, with at least four meals per day.

iv) Consult with a dietitian to provide a diet high in calories, protein,

carbohydrates, and vitamins.

v) Administer medications as indicated:

i) to obtain baseline data.

ii) Aids in

keeping caloric intake high enough to keep up with the rapid expenditure of calories caused by the

hypermetabolic state.

iii) To promote weight gain.

iv) to ensure adequate intake of nutrients, identify appropriate supplements.

v) Given to meet energy

requirements

Patient showed no sign of

infection throughout period of

hospitalization

Nursing care plan for Patient with Hyperthyroidism

Diagnosis Nursing

objective Nursing

intervention Scientific

rationel Evaluation Ineffective

breathing pattern related to

depressed ventilation evidence by nurse’s observation

Patient’s

respiratory rate will be reduced to16 to 20 cycle per minute after 30 to 40 minutes of nurse’s

intervention

1. Monitor

respiratory rate, depth, pattern, pulse oximetry, and arterial blood gases.

2. Encourage deep breathing and coughing.

3. Administer medications (hypnotics and sedatives) with caution.

4. Maintain patent airway through suction and ventilator support if indicated

1. Obtain baseline data 2. promotes adequate ventilation 3. Patients with hypothyroidism are very

susceptible to respiratory

depression with use of hypnotics and sedatives.

4. Use of an artificial airway and ventilator support may be necessary with respiratory depression.

Patient

respiratory rate was reduced to 18 cycle per minute after 35 minutes of nurse’s

intervention.

Risk for

imbalanced body temperature

related to medical condition

Patient’s body temperature will be maintained throughout hospitalization

1.Provide extra layer of clothing or extra blanket.

2. Avoid and discourage use of external heat source .

3. Monitor patient’s body temperature and report decreases from patient’s baseline value.

4. Protect from exposure to cold and drafts.

1. Minimizes heat loss

2. Reduces risk of peripheral vasodilation and vascular collapse 3. Detects

decreased body temperature and onset of

myxedema coma 4. Increases

patient’s level of comfort and decreases further heat loss

Patient’s

temperature was maintained

throughout

Hospitalization.

Nursing care plan for patient with Hypothyroidism

Diagnosis Nursing

objective Nursing intervention Scientific

rationale Evaluation Fatigue related to

Hyper metabolic state with

increased energy requirements evidenced by verbalization.

Patient will verbalize increase in the level of energy within 30 min to1 hour of nursing intervention

i) Monitor vital signs.

ii) Provide comfort measures: touch therapy or massage, cool showers.

iii) Provide for

diversional activities that are calming, e.g., reading, radio,

television.

iv) Administer medications as

indicated: Sedatives such as phenobarbital (Luminal); antianxiety agents;

chlordiazepoxide (Librium).

i) To observe baseline data.

ii) May decrease nervous energy, promoting

relaxation.

iii) Allows for use of nervous energy in a constructive manner and may reduce anxiety.

iv) reduce nervousness, hyperactivity, and insomnia.

Patient verbalized and

increase in energy after 45 minutes of nursing interventio n

Anxiety related to hyper

metabolic state evidenced by patients facial expression

Patient will appear relaxed within 30 to 45mins of nursing

intervention.

Observe behavior

indicative of the level of anxiety.

Speak in brief statements.

Use simple words.

Reduce external stimuli:

Place in a quiet room;

provide soft, soothing music;

reduce bright lights; reduce the number of persons

having contact with the patient.

Administer antianxiety agents or sedatives and monitor effects.

i) to obtain baseline data ii) Attention span may be shortened, concentration reduced,

limiting the ability to assimilate information.

iii) Creates a therapeutic environment iv) used with a medical regimen to reduce effects of hyperthyroid secretion

Patient appeared relaxed after 30min of nursing interventio n.

In document Development and evaluation of fire retardent unsaturated polyester clay nanocomposites (Page 99-104)