Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 8 Endocrine System^339


INTERPRETING TEST RESULTS



  • Decreased or normal serum T4 level caused by an underactive thyroid.

  • Increased serum TSH, by the pituitary gland, attempting to stimulate or shut
    off production of the thyroid in making thyroid hormone.

  • RAIU uptake normal or increased—a radioactive isotope is injected into a
    vein. A scan of the thyroid is done to visualize the thyroid more completely.

  • Ultrasound enables sound waves to bounce off the gland, giving the size and
    location of any nodules.


TREATMENT



  • If increased TSH, administer hormone replacement with levothyroxine (T4),
    dessicated thyroid, or liothyronine (T3).

  • If the thyroid gland is overactive, then administer small doses of Lugol’s
    solution or potassium iodide solution.

  • If the simple goiter cannot be reduced through medication, then a thyroid-
    ectomy is performed during which all or part of the thyroid is removed.


NURSING DIAGNOSES



  • Imbalanced nutrition: less than what body requires; related to inadequate in-
    take in relation to metabolic needs

  • Fatigue related to sleep deprivation

  • Hyperthermia related to increased metabolic rate


NURSING INTERVENTION



  • Avoid goitrogenic foods or drugs in sporadic goiter since they make thyroid
    hormone production.

  • Use iodized salt to prevent and treat endemic goiter, since the thyroid needs
    iodine to make thyroid hormone.

  • Explain to patient:

    • The need for life-long thyroid replacement after thyroidectomy and radio-
      active iodine.



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