Medical-surgical Nursing Demystified

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.