Materiały źródłowe

• #1 Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics

  Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. It is the most common thyroid disorder. […] The goal of treatment is to return blood levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) to the normal range and to relieve symptoms. This is done with daily thyroid hormone replacement therapy. […] Thyroid hormone replacement is usually given as an oral (pill) form of T4, called „levothyroxine.” Most people with hypothyroidism need to keep taking daily levothyroxine for the rest of their life. This gives your body the right level of the hormone that it cannot make on its own. […] In most cases, symptoms of hypothyroidism begin to improve within two weeks of starting thyroid replacement therapy. However, people with more severe symptoms, especially muscle pain and weakness, may require several months of treatment before they fully recover.

• #2 Hypothyroidism – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-disorders/hypothyroidism

  Hypothyroidism is thyroid hormone deficiency. Symptoms include cold intolerance, fatigue, and weight gain. Signs may include a typical facial appearance, hoarse slow speech, and dry skin. Diagnosis is with thyroid function tests. Management includes administration of thyroxine. […] Hypothyroidism is particularly common among older adults. It occurs in close to 10% of women and 6% of men 65 years. Although typically easy to diagnose in younger adults, hypothyroidism may be subtle and manifest atypically in older adults. […] In older patients, levothyroxine therapy is begun with low doses, usually 25 mcg once a day. Maintenance doses may also need to be lower in older patients. […] Treat with levothyroxine and adjust dose until TSH levels are normal. Treat with levothyroxine and adjust dose until TSH levels are normal. […] Check cortisol levels in patients with secondary hypothyroidism before starting thyroid replacement therapy, because of the serious risk of adrenal crisis.

• #3 Hypothyroidism – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-disorders/hypothyroidism

  Hypothyroidism is thyroid hormone deficiency. Symptoms include cold intolerance, fatigue, and weight gain. Signs may include a typical facial appearance, hoarse slow speech, and dry skin. Diagnosis is with thyroid function tests. Management includes administration of thyroxine. […] Hypothyroidism is particularly common among older adults. It occurs in close to 10% of women and 6% of men 65 years. Although typically easy to diagnose in younger adults, hypothyroidism may be subtle and manifest atypically in older adults. […] In older patients, levothyroxine therapy is begun with low doses, usually 25 mcg once a day. Maintenance doses may also need to be lower in older patients. […] Treat with levothyroxine and adjust dose until TSH levels are normal. Treat with levothyroxine and adjust dose until TSH levels are normal. […] Check cortisol levels in patients with secondary hypothyroidism before starting thyroid replacement therapy, because of the serious risk of adrenal crisis.

• #4 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Effective treatment should achieve a clinical improvement of signs and symptoms, along with an improved sense of patient well-being and normal TSH or free T4 levels. […] Hypothyroidism affects multiple organ systems across all age groups and affects patient well-being and ability to function daily. Treatment is with levothyroxine monotherapy. […] Advise patients that treatment for hypothyroidism is lifelong. Instruct clients to take medications 30 to 60 minutes before the first meal of the day is essential. Also, inform patients not to take thyroid medications with other medications, as several food and medication interactions may occur.

• #5 Hypothyroidism (underactive thyroid) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

  Hypothyroidism happens when the thyroid gland doesn’t make enough thyroid hormone. This condition also is called underactive thyroid. […] Treatment with thyroid hormone medicine usually is simple, safe and effective once you and your health care provider find the right dosage for you. […] If you’re taking thyroid hormone medicine for hypothyroidism, follow your health care provider’s advice on how often you need medical appointments. At first, you may need regular appointments to make sure you’re receiving the right dose of medicine. Over time, you may need checkups so that your health care provider can monitor your condition and medicine. […] Hypothyroidism that isn’t treated can lead to other health problems, including: […] Infants with hypothyroidism present at birth that goes untreated are at risk of serious physical and mental development problems. But if the condition is diagnosed within the first few months of life, the chances of typical development are excellent.

• #6 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Hypothyroidism Nursing Care Plan […] Nursing Considerations […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for hypothyroidism are listed below. […] Assessment […] Assess signs and symptoms, such as (Patil et al., 2021): […] Vital signs […] Dry skin […] Sleep disturbances […] Loss of hair […] Constipation […] Fatigue […] Intolerant to cold temperatures […] Intolerance to cold […] Menstrual cycle changes […] Weight gain […] Appetite changes […] Energy level […] Change in voice […] Muscle strength and tone […] Fluid intake […] Family history of thyroid disease […] Anxiety, depression, or psychosis […] Memory difficulty or loss

• #7 Special Populations

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/understanding-hypothyroidism-and-hyperthyroidism

  Hypothyroidism is a state of low circulating thyroid hormones. […] Hypothyroidism results in the slowing down of many physical and mental processes. Myxedema coma, the decompensated severe form of hypothyroidism, is a medical emergency that warrants immediate treatment with thyroid hormone and intensive care unit admission (Ross, 2024a). […] Thyroid replacement, using a form of T4 (levothyroxine sodium), is the preferred treatment that requires only once-a-day dosing. […] Patients should be monitored closely until stable. After TSH is stabilized, maintenance therapy should be continued with annual or semiannual TSH testing. Effective treatment should improve or resolve most signs and symptoms. […] Inform patient that thyroid replacement treatment will likely continue for life. […] Advise patient that medication should be taken at the same time each day on an empty stomach (at least one hour before other medications). […] Teach patient that reduced absorption can occur when taken with calcium, iron, vitamins, antacids, colestipol (or other medications that bind bile acids), and fiber supplements. […] Manage constipation with laxatives and dry skin with moisturizer. […] Signs and symptoms of hypothyroidism may be very subtle and mistakenly attributed to normal aging changes. […] Taking a careful history is important to make the correct diagnosis and helps to avoid erroneous diagnoses of heart failure, dementia, or depression.

• #8 Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289

  The symptoms of hypothyroidism can be different from person to person. […] A diagnosis of hypothyroidism doesn’t rely on symptoms alone. It’s usually based on the results of blood tests. […] TSH tests also play an important role in managing hypothyroidism over time. They help your health care provider find and maintain the right dosage of medication for you. […] Treatment for hypothyroidism usually includes taking the thyroid hormone medicine levothyroxine (Levo-T, Synthroid, others) every day. […] Treatment with levothyroxine likely will be lifelong. […] To find the right dosage of levothyroxine for you, your health care provider checks your level of TSH about 6 to 8 weeks after you start taking the medicine. […] Levothyroxine typically causes no side effects when used in the correct dose.

• #9 Hypothyroidism and nursing care – American Nurse Today

  https://www.myamericannurse.com/hypothyroidism-nursing-care/

  Hypothyroidism and nursing care […] Learn to recognize the symptoms of this commonly overlooked condition. […] Hypothyroidism, also known as myxedema, is second to diabetes mellitus as the most common endocrine disorder in the United States. Its six times more likely to occur in women than men and is more common in older people. About 10% of women over age 60 have subclinical hypothyroidism. Because it affects all of the bodys systems, mimicking many other disease processes, hypothyroidism can be overlooked as an explanation for a patients clinical presentation. This article reviews the pathophysiology of hypothyroidism, as well as its causes, symptoms, diagnosis, treatment, and nursing care. […] Hypothyroidism is diagnosed when a person has an elevated serum TSH level and a low serum free T4 level.

• #10 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Hypothyroidism Nursing Care Plan […] Nursing Considerations […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for hypothyroidism are listed below. […] Assessment […] Assess signs and symptoms, such as (Patil et al., 2021): […] Vital signs […] Dry skin […] Sleep disturbances […] Loss of hair […] Constipation […] Fatigue […] Intolerant to cold temperatures […] Intolerance to cold […] Menstrual cycle changes […] Weight gain […] Appetite changes […] Energy level […] Change in voice […] Muscle strength and tone […] Fluid intake […] Family history of thyroid disease […] Anxiety, depression, or psychosis […] Memory difficulty or loss

• #11 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Periorbital edema […] Palpitations or racing heart […] Neck for enlarged thyroid or nodules […] Reflex time […] Thyroid levels: […] Thyroid-stimulating hormone […] Free T4 […] Thyroid peroxidase antibodies […] Anti-thyroglobulin antibodies […] Laboratory results for: […] Hyperlipidemia […] Serum creatinine kinase […] Hepatic enzymes […] Hemoglobin […] Blood urea nitrogen […] Creatinine […] Uric acid […] Hypothyroidism Nursing Diagnosis/Risk For […] Imbalanced nutrition: More than body requirements as evidenced by (Phelps, 2021a): […] Change in appetite […] Sedentary lifestyle […] Weight gain […] Activity intolerance related to impaired metabolic state as evidenced by (Phelps, 2021b): […] Overwhelming lack of energy […] Inability to complete desired activities

• #12 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Periorbital edema […] Palpitations or racing heart […] Neck for enlarged thyroid or nodules […] Reflex time […] Thyroid levels: […] Thyroid-stimulating hormone […] Free T4 […] Thyroid peroxidase antibodies […] Anti-thyroglobulin antibodies […] Laboratory results for: […] Hyperlipidemia […] Serum creatinine kinase […] Hepatic enzymes […] Hemoglobin […] Blood urea nitrogen […] Creatinine […] Uric acid […] Hypothyroidism Nursing Diagnosis/Risk For […] Imbalanced nutrition: More than body requirements as evidenced by (Phelps, 2021a): […] Change in appetite […] Sedentary lifestyle […] Weight gain […] Activity intolerance related to impaired metabolic state as evidenced by (Phelps, 2021b): […] Overwhelming lack of energy […] Inability to complete desired activities

• #13 Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289

  The symptoms of hypothyroidism can be different from person to person. […] A diagnosis of hypothyroidism doesn’t rely on symptoms alone. It’s usually based on the results of blood tests. […] TSH tests also play an important role in managing hypothyroidism over time. They help your health care provider find and maintain the right dosage of medication for you. […] Treatment for hypothyroidism usually includes taking the thyroid hormone medicine levothyroxine (Levo-T, Synthroid, others) every day. […] Treatment with levothyroxine likely will be lifelong. […] To find the right dosage of levothyroxine for you, your health care provider checks your level of TSH about 6 to 8 weeks after you start taking the medicine. […] Levothyroxine typically causes no side effects when used in the correct dose.

• #14 Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics

  Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. It is the most common thyroid disorder. […] The goal of treatment is to return blood levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) to the normal range and to relieve symptoms. This is done with daily thyroid hormone replacement therapy. […] Thyroid hormone replacement is usually given as an oral (pill) form of T4, called „levothyroxine.” Most people with hypothyroidism need to keep taking daily levothyroxine for the rest of their life. This gives your body the right level of the hormone that it cannot make on its own. […] In most cases, symptoms of hypothyroidism begin to improve within two weeks of starting thyroid replacement therapy. However, people with more severe symptoms, especially muscle pain and weakness, may require several months of treatment before they fully recover.

• #15 Hypothyroidism (underactive thyroid) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

  Hypothyroidism happens when the thyroid gland doesn’t make enough thyroid hormone. This condition also is called underactive thyroid. […] Treatment with thyroid hormone medicine usually is simple, safe and effective once you and your health care provider find the right dosage for you. […] If you’re taking thyroid hormone medicine for hypothyroidism, follow your health care provider’s advice on how often you need medical appointments. At first, you may need regular appointments to make sure you’re receiving the right dose of medicine. Over time, you may need checkups so that your health care provider can monitor your condition and medicine. […] Hypothyroidism that isn’t treated can lead to other health problems, including: […] Infants with hypothyroidism present at birth that goes untreated are at risk of serious physical and mental development problems. But if the condition is diagnosed within the first few months of life, the chances of typical development are excellent.

• #16 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes. […] Symptom relief and normalized thyroid-stimulating hormone levels are achieved with levothyroxine replacement therapy, started at 1.5 to 1.8 mcg per kg per day. Patients older than 60 years or with known or suspected ischemic heart disease should start at a lower dosage of levothyroxine (12.5 to 50 mcg per day). […] Women with hypothyroidism who become pregnant should increase their weekly dosage by 30% up to nine doses per week (i.e., take one extra dose twice per week), followed by monthly evaluation and management.

• #17 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  A recent systematic review concluded that most non-pregnant individuals with subclinical hypothyroidism do not benefit from treatment. […] Age-specific local reference ranges for TSH should be considered when establishing a diagnosis of subclinical hypothyroidism, particularly in older people. […] Most elderly patients with subclinical hypothyroidism should be carefully followed up with a wait and see strategy, generally avoiding replacement therapy. […] The goals of therapy for hypothyroidism include: amelioration of hypothyroid symptoms, restoration of a euthyroid state, avoidance of overtreatment. […] Restoration of a euthyroid state can be readily accomplished in almost all patients by oral administration of LT4. […] The average full replacement dose of LT4 in adults is approximately 1.6 g/kg body weight per day.

• #18 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes. […] Symptom relief and normalized thyroid-stimulating hormone levels are achieved with levothyroxine replacement therapy, started at 1.5 to 1.8 mcg per kg per day. Patients older than 60 years or with known or suspected ischemic heart disease should start at a lower dosage of levothyroxine (12.5 to 50 mcg per day). […] Women with hypothyroidism who become pregnant should increase their weekly dosage by 30% up to nine doses per week (i.e., take one extra dose twice per week), followed by monthly evaluation and management.

• #19 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  Patients with persistent symptoms after adequate levothyroxine dosing should be reassessed for other causes or the need for referral. […] Early recognition of myxedema coma and appropriate treatment is essential. […] Most patients with subclinical hypothyroidism do not benefit from treatment unless the thyroid-stimulating hormone level is greater than 10 mIU per L or the thyroid peroxidase antibody is elevated. […] Clinical hypothyroidism should be treated with levothyroxine to normalize the TSH level and relieve signs and symptoms. […] Levothyroxine should be taken once per day, 30 to 60 minutes before eating, and four hours before or after drugs that may impede absorption. […] In patients who are not pregnant, TSH should be monitored every six to eight weeks until within normal range, then every six to 12 months, barring a change in clinical status.

• #20 Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289

  If you have coronary artery disease or severe hypothyroidism, your health care provider may start treatment with a smaller amount of medicine and then slowly increase the dosage. […] Levothyroxine is best taken on an empty stomach at the same time every day. […] Don’t skip doses or stop taking the medicine because you feel better. […] If you are diagnosed with subclinical hypothyroidism, talk about treatment with your health care provider.

• #21 Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics

  Levothyroxine should be taken once per day on an empty stomach (ideally one hour before eating or four hours after). Most people take their medication as soon as they wake in the morning and delay eating breakfast as long as practical before leaving for work or school. […] Most people with hypothyroidism require lifelong treatment, although the dose of levothyroxine may need to be adjusted over time. […] Changes in the levothyroxine dose usually are based upon your TSH level. Your dose may need to be increased if thyroid disease worsens, you get pregnant, gastrointestinal conditions impair levothyroxine absorption, or you gain weight. […] The decision to treat subclinical hypothyroidism with levothyroxine is controversial. We treat all patients with a TSH >7 to 10 mU/L. […] Some doctors treat hypothyroidism with liothyronine (T3) pills in addition to levothyroxine (T4). This is controversial because most studies have not found a benefit. However, this might be an option if your symptoms do not improve enough with levothyroxine alone.

• #22

  https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/treatment/

  An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called levothyroxine. […] You’ll initially have regular blood tests until the correct dose of levothyroxine is reached. This can take a little while to get right. […] Once you’re taking the correct dose, you’ll usually have a blood test once a year to monitor your hormone levels. […] If blood tests suggest you may have an underactive thyroid, but you do not have any symptoms or they’re very mild, you may not need any treatment. […] If you’re prescribed levothyroxine, you should take it at the same time every day. […] An underactive thyroid is a lifelong condition, so you’ll usually need to take levothyroxine for the rest of your life. […] If you’re prescribed levothyroxine because you have an underactive thyroid, you’re entitled to a medical exemption certificate.

• #23 Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289

  The symptoms of hypothyroidism can be different from person to person. […] A diagnosis of hypothyroidism doesn’t rely on symptoms alone. It’s usually based on the results of blood tests. […] TSH tests also play an important role in managing hypothyroidism over time. They help your health care provider find and maintain the right dosage of medication for you. […] Treatment for hypothyroidism usually includes taking the thyroid hormone medicine levothyroxine (Levo-T, Synthroid, others) every day. […] Treatment with levothyroxine likely will be lifelong. […] To find the right dosage of levothyroxine for you, your health care provider checks your level of TSH about 6 to 8 weeks after you start taking the medicine. […] Levothyroxine typically causes no side effects when used in the correct dose.

• #24 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  The treatment goals for hypothyroidism are to reverse clinical progression and correct metabolic derangements, as evidenced by normal blood levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4). Thyroid hormone is administered to supplement or replace endogenous production. In general, hypothyroidism can be adequately treated with a constant daily dose of levothyroxine (LT4). […] Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a TSH level within the reference range may take several months because of delayed readaptation of the hypothalamic-pituitary axis. In patients receiving treatment with LT4, dosing changes should be made every 4-6 weeks until the patients TSH is in target range. […] After dosage stabilization, patients can be monitored with annual or semiannual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of overtreatment, which include the following: Tachycardia, Palpitations, Atrial fibrillation, Nervousness, Tiredness, Headache, Increased excitability, Sleeplessness, Tremors, Possible angina.

• #25 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  In older adults, hypothyroidism may have a subtle or more nonspecific presentation. […] For older patients or those with coronary artery disease, levothyroxine therapy should be started at 25 to 50 mcg per day, with titration of 25 mcg every three to four weeks until a target dosage is achieved to decrease the potential for adverse effects from thyroid excess. […] Pregnancy is associated with increased levothyroxine requirements as early as the fourth week of gestation. […] Once pregnancy is confirmed, patients with existing hypothyroidism should start taking an extra dose of levothyroxine two days per week for a total of nine doses per week. […] Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications.

• #26 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  Because co-administration of food with the medication can impair LT4 absorption, the medication should be taken while fasting at least 30 minutes and ideally 60 minutes before breakfast. […] Patients with overt hypothyroidism should generally have the LT4 dose adjusted to achieve a normal TSH level to avoid these potential adverse effects. […] Patients with hypothyroidism who are maintained on LT4 therapy should increase the dosage of their medication initially by approximately 25% as soon as pregnancy has been confirmed. […] Regular monitoring of serum TSH and FT4 levels is recommended, particularly during the first half of gestation, to adjust the LT4 dosage to maintain these parameters within the normal pregnancy reference range (0.12.5 mIU/L). […] The hypothyroid phase is usually transient; therefore, thyroxine replacement may not be required.

• #27 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  Because co-administration of food with the medication can impair LT4 absorption, the medication should be taken while fasting at least 30 minutes and ideally 60 minutes before breakfast. […] Patients with overt hypothyroidism should generally have the LT4 dose adjusted to achieve a normal TSH level to avoid these potential adverse effects. […] Patients with hypothyroidism who are maintained on LT4 therapy should increase the dosage of their medication initially by approximately 25% as soon as pregnancy has been confirmed. […] Regular monitoring of serum TSH and FT4 levels is recommended, particularly during the first half of gestation, to adjust the LT4 dosage to maintain these parameters within the normal pregnancy reference range (0.12.5 mIU/L). […] The hypothyroid phase is usually transient; therefore, thyroxine replacement may not be required.

• #28 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  The treatment goals for hypothyroidism are to reverse clinical progression and correct metabolic derangements, as evidenced by normal blood levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4). Thyroid hormone is administered to supplement or replace endogenous production. In general, hypothyroidism can be adequately treated with a constant daily dose of levothyroxine (LT4). […] Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a TSH level within the reference range may take several months because of delayed readaptation of the hypothalamic-pituitary axis. In patients receiving treatment with LT4, dosing changes should be made every 4-6 weeks until the patients TSH is in target range. […] After dosage stabilization, patients can be monitored with annual or semiannual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of overtreatment, which include the following: Tachycardia, Palpitations, Atrial fibrillation, Nervousness, Tiredness, Headache, Increased excitability, Sleeplessness, Tremors, Possible angina.

• #29 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  The treatment goals for hypothyroidism are to reverse clinical progression and correct metabolic derangements, as evidenced by normal blood levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4). Thyroid hormone is administered to supplement or replace endogenous production. In general, hypothyroidism can be adequately treated with a constant daily dose of levothyroxine (LT4). […] Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a TSH level within the reference range may take several months because of delayed readaptation of the hypothalamic-pituitary axis. In patients receiving treatment with LT4, dosing changes should be made every 4-6 weeks until the patients TSH is in target range. […] After dosage stabilization, patients can be monitored with annual or semiannual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of overtreatment, which include the following: Tachycardia, Palpitations, Atrial fibrillation, Nervousness, Tiredness, Headache, Increased excitability, Sleeplessness, Tremors, Possible angina.

• #30 Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics

  Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. It is the most common thyroid disorder. […] The goal of treatment is to return blood levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) to the normal range and to relieve symptoms. This is done with daily thyroid hormone replacement therapy. […] Thyroid hormone replacement is usually given as an oral (pill) form of T4, called „levothyroxine.” Most people with hypothyroidism need to keep taking daily levothyroxine for the rest of their life. This gives your body the right level of the hormone that it cannot make on its own. […] In most cases, symptoms of hypothyroidism begin to improve within two weeks of starting thyroid replacement therapy. However, people with more severe symptoms, especially muscle pain and weakness, may require several months of treatment before they fully recover.

• #31 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Effective treatment should achieve a clinical improvement of signs and symptoms, along with an improved sense of patient well-being and normal TSH or free T4 levels. […] If symptoms persist despite normalization of TSH/free T4 levels, then consultation with an endocrinologist should also be considered.

• #32 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Effective treatment should achieve a clinical improvement of signs and symptoms, along with an improved sense of patient well-being and normal TSH or free T4 levels. […] Hypothyroidism affects multiple organ systems across all age groups and affects patient well-being and ability to function daily. Treatment is with levothyroxine monotherapy. […] Advise patients that treatment for hypothyroidism is lifelong. Instruct clients to take medications 30 to 60 minutes before the first meal of the day is essential. Also, inform patients not to take thyroid medications with other medications, as several food and medication interactions may occur.

• #33 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Effective treatment should achieve a clinical improvement of signs and symptoms, along with an improved sense of patient well-being and normal TSH or free T4 levels. […] If symptoms persist despite normalization of TSH/free T4 levels, then consultation with an endocrinologist should also be considered.

• #34 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Monitor for signs and symptoms of overtreatment with levothyroxine. Indications of overtreatment mimic signs and symptoms of hyperthyroidism, such as anxiety, palpitations, tachycardia, heat intolerance, fever, excessive sweating, changes in appetite, and weight loss. Report any signs of cardiac excitability, chest pain, and dysrhythmias to the medical provider.

• #35 6 Hypothyroidism (Myxedema) Nursing Care Plans

  https://nurseslabs.com/hypothyroidism-nursing-care-plans/

  Hypothyroidism is a common endocrine disorder that can have a significant impact on a patients health. As a nurse, you play a crucial role in managing this condition and improving patient outcomes. With these nursing care plans, youll be better equipped to provide effective care for Hypothyroidism patients. […] The nursing care plan for clients with hypothyroidism includes providing information about disease process/prognosis and therapy needs, guiding the client to meet their nutritional requirement, planning activities with a rest period, and preventing complications. […] The following are the nursing priorities for patients with hypothyroidism: […] Administer prescribed thyroid hormone replacement medications to patients. […] Educate patients about the importance of medication adherence and potential side effects.

• #36 Evidence based nursing care guidelines of adult patients with Hypothyroidism | Abstract

  https://www.hilarispublisher.com/abstract/evidence-based-nursing-care-guidelines-of-adult-patients-with-hypothyroidism-68246.html

  Objective: Hypothyroidism is an endocrine disorder. In hypothyroidism patient has an underactive Thyroid (“hypo-” means “under” or “below normal”). In patients with hypothyroidism, the Thyroid does not make enough Thyroid hormone to keep the body maintain its normal balance. Common causes of hypothyroidism are autoimmune disease, surgical removal of the Thyroid, and radiation treatment. The objective of this literature review is to present the evidence based nursing practice for patients with hypothyroidism. […] […] Results: The evidence based nursing suggests that nurses should monitor vital signs of patients with hypothyroidism because fluctuations in metabolic rate are exhibited by changes in blood pressure, heart rate, and body temperature. Also, nurses should watch for the reduction in symptoms related to hypothyroidism such as fatigue, constipation, cold intolerance, lethargy, depression, and menstrual irregularities, it demonstrate that patient is getting therapeutic effect from drug. Nursing intervention should also include watching for the symptoms of hyperthyroidism such as nervousness, insomnia, tachycardia, dysrhythmias, heat intolerance, chest pain, and diarrhea as these symptoms may indicate that the drug is at a toxic level. Moreover, evidence based nursing care recommends to monitor T3, T4, and TSH levels as these levels help determine the effectiveness of pharmacotherapy. Monitoring of blood glucose levels, especially in individuals with Diabetes Mellitus is important as hormone can increases metabolic rate, and glucose utilization may be altered. Most importantly, nurses should provide supportive nursing care to cope with symptoms of hypothyroidism such as constipation, cold intolerance, and fatigue until drug has achieved therapeutic effects as it will decrease the client’s anxiety, which will promote healing and compliance. Nursing intervention also includes monitor weight once a week as weight loss is expected because of increased metabolic rate as these changes help determine the effectiveness of drug therapy. Furthermore, nurses should monitor patients for signs of decreased compliance with therapeutic regimen as it may require early intervention and education about the medical regimen and the disease process. […]

• #37 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Deficient knowledge: Disease process as evidenced by: (Phelps, 2021c): […] New disease process […] Lack of compliance with medication […] Interventions […] Monitor vital signs […] Encourage six small meals daily […] Encourage diet rich in fiber and low in cholesterol, calories, and saturated fats […] Promote rest periods between activities […] Adjust climate to a comfortable temperature for the individual […] Administer medications as ordered, in the morning or on an empty stomach […] Insert IV if admitted for monitoring […] Monitor heart rhythm […] Offer emotional support […] Provide meticulous skincare […] Seizure precautions […] Monitor lab results […] Monitor treatment response […] Expected Outcomes […] TSH levels return to normal […] States improved feeling of wellbeing

• #38 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Monitor for signs and symptoms of overtreatment with levothyroxine. Indications of overtreatment mimic signs and symptoms of hyperthyroidism, such as anxiety, palpitations, tachycardia, heat intolerance, fever, excessive sweating, changes in appetite, and weight loss. Report any signs of cardiac excitability, chest pain, and dysrhythmias to the medical provider.

• #39 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  The treatment goals for hypothyroidism are to reverse clinical progression and correct metabolic derangements, as evidenced by normal blood levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4). Thyroid hormone is administered to supplement or replace endogenous production. In general, hypothyroidism can be adequately treated with a constant daily dose of levothyroxine (LT4). […] Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a TSH level within the reference range may take several months because of delayed readaptation of the hypothalamic-pituitary axis. In patients receiving treatment with LT4, dosing changes should be made every 4-6 weeks until the patients TSH is in target range. […] After dosage stabilization, patients can be monitored with annual or semiannual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of overtreatment, which include the following: Tachycardia, Palpitations, Atrial fibrillation, Nervousness, Tiredness, Headache, Increased excitability, Sleeplessness, Tremors, Possible angina.

• #40 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Monitor for signs and symptoms of overtreatment with levothyroxine. Indications of overtreatment mimic signs and symptoms of hyperthyroidism, such as anxiety, palpitations, tachycardia, heat intolerance, fever, excessive sweating, changes in appetite, and weight loss. Report any signs of cardiac excitability, chest pain, and dysrhythmias to the medical provider.

• #41 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Deficient knowledge: Disease process as evidenced by: (Phelps, 2021c): […] New disease process […] Lack of compliance with medication […] Interventions […] Monitor vital signs […] Encourage six small meals daily […] Encourage diet rich in fiber and low in cholesterol, calories, and saturated fats […] Promote rest periods between activities […] Adjust climate to a comfortable temperature for the individual […] Administer medications as ordered, in the morning or on an empty stomach […] Insert IV if admitted for monitoring […] Monitor heart rhythm […] Offer emotional support […] Provide meticulous skincare […] Seizure precautions […] Monitor lab results […] Monitor treatment response […] Expected Outcomes […] TSH levels return to normal […] States improved feeling of wellbeing

• #42 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Decrease in symptoms […] Increased energy […] Individual/Caregiver Education […] Condition, treatment, and expected outcomes […] Notify healthcare provider or seek immediate medical care for: […] No improvement of symptoms […] Worsening of symptoms […] Palpitations or racing heart […] Change in behavior or mental status […] Slow breathing or shortness of breath […] Increased swelling of hands, feet, or face […] Increased appetite […] Insomnia […] Shakiness […] Weight changes and body requirements with hypothyroidism […] Thyroid hormones and compliance […] Not to stop taking the medication without contacting a healthcare provider […] Benefits, side effects, and interactions of medications […] Follow-up visits with a healthcare provider

• #43 Hypothyroidism Nursing Care Management and Study Guide

  https://nurseslabs.com/hypothyroidism/

  Learn about the nursing care management of patients with hypothyroidism in this nursing study guide. […] Nursing care for a patient with hypothyroidism includes the following: […] Assessment of the patient with hypothyroidism should include: […] Based on the assessment data, the nursing diagnoses appropriate for a patient with hypothyroidism are: […] To achieve a successful nursing care plan, the following goals should be realized: […] Nursing interventions for a patient with hypothyroidism include the following: […] A successful nursing care plan has achieved the following goals: […] At the completion of the home care instruction, the patient or caregiver will be able to: […] The focus of documentation should include:

• #44 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  Patients with severe hypothyroidism requiring hospitalization (eg, myxedema) may need aggressive management. Overreplacement or aggressive replacement with any thyroid hormone may precipitate tachyarrhythmias or, very rarely, thyroid storm and should be balanced against the need for urgent replacement. […] Indications for referral to an endocrinologist include any of the following: A nodular thyroid, suspicious thyroid nodules, or compressive symptoms (eg, dysphagia), Pregnancy (or planned pregnancy), Underlying cardiac disorders or other endocrine disorders, Age younger than 18 years, Secondary or tertiary hypothyroidism, Unusual constellation of thyroid function test results, Inability to maintain TSH in the target range, Unresponsiveness to treatment. […] Once an appropriate therapeutic dosage is arrived at, patients can be monitored annually or semiannually with laboratory evaluation and physical examination. In addition, monitor patients for signs of excess dosing (eg, nervousness, palpitations, diarrhea, excessive sweating, heat intolerance, chest pain, or insomnia).

• #45 Med-Surg Nursing: Hypothyroidism & Myxedema Coma – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-14-hypothyroidism-myxedema-coma?srsltid=AfmBOoqDxizpCndzg6R4IdZqWDuOrmMhVtJlEJdzPJ3wVEan9N5nZChV

  Hypothyroidism is a disease marked by inadequate production of T3 and T4, which are thyroid hormones from the thyroid gland. […] The treatment for hypothyroidism is synthetic thyroid hormones, including levothyroxine (Synthroid, T4) and liothyroxine (Cytomel). These medications replace the thyroid hormones that the body is not producing enough of. The patient will need to take this medication as a lifelong treatment. […] For patients with hypothyroidism there are some nursing care and patient teaching tactics you can employ. Encourage frequent rest periods (to help with their lethargy). Encourage a low-calorie, high-fiber diet to promote weight loss and prevent constipation. Increase the patient’s room temperature and provide blankets (to help with their cold intolerance). […] The most important nursing care priority when responding to a myxedema coma is maintaining a patent airway.

• #46 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Periorbital edema […] Palpitations or racing heart […] Neck for enlarged thyroid or nodules […] Reflex time […] Thyroid levels: […] Thyroid-stimulating hormone […] Free T4 […] Thyroid peroxidase antibodies […] Anti-thyroglobulin antibodies […] Laboratory results for: […] Hyperlipidemia […] Serum creatinine kinase […] Hepatic enzymes […] Hemoglobin […] Blood urea nitrogen […] Creatinine […] Uric acid […] Hypothyroidism Nursing Diagnosis/Risk For […] Imbalanced nutrition: More than body requirements as evidenced by (Phelps, 2021a): […] Change in appetite […] Sedentary lifestyle […] Weight gain […] Activity intolerance related to impaired metabolic state as evidenced by (Phelps, 2021b): […] Overwhelming lack of energy […] Inability to complete desired activities

• #47 6 Hypothyroidism (Myxedema) Nursing Care Plans

  https://nurseslabs.com/hypothyroidism-nursing-care-plans/

  Assess and manage symptoms associated with hypothyroidism, such as fatigue, weight gain, and cold intolerance. […] Goals and expected outcomes may include: […] The client will maintain a stable weight and takes in necessary nutrients. […] The client and family members will verbalize correct information about hypothyroidism and taking thyroid hormone replacement. […] The client will verbalize a reduction of fatigue and increased ability to complete desired activities. […] Nursing care plans for hypothyroidism patients aim to address this imbalance through dietary interventions and monitoring of nutritional status. […] Therapeutic interventions and nursing actions for patients with hypothyroidism may include: […] Fatigue is a common symptom of hypothyroidism due to the slower metabolic rate and reduced energy production in the body. Nursing care plans for hypothyroidism patients should consider this risk and focus on promoting rest and adequate sleep, conserving energy during activities of daily living, and optimizing thyroid hormone replacement therapy to improve energy levels and reduce fatigue.

• #48 6 Hypothyroidism (Myxedema) Nursing Care Plans

  https://nurseslabs.com/hypothyroidism-nursing-care-plans/

  Assess and manage symptoms associated with hypothyroidism, such as fatigue, weight gain, and cold intolerance. […] Goals and expected outcomes may include: […] The client will maintain a stable weight and takes in necessary nutrients. […] The client and family members will verbalize correct information about hypothyroidism and taking thyroid hormone replacement. […] The client will verbalize a reduction of fatigue and increased ability to complete desired activities. […] Nursing care plans for hypothyroidism patients aim to address this imbalance through dietary interventions and monitoring of nutritional status. […] Therapeutic interventions and nursing actions for patients with hypothyroidism may include: […] Fatigue is a common symptom of hypothyroidism due to the slower metabolic rate and reduced energy production in the body. Nursing care plans for hypothyroidism patients should consider this risk and focus on promoting rest and adequate sleep, conserving energy during activities of daily living, and optimizing thyroid hormone replacement therapy to improve energy levels and reduce fatigue.

• #49 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Deficient knowledge: Disease process as evidenced by: (Phelps, 2021c): […] New disease process […] Lack of compliance with medication […] Interventions […] Monitor vital signs […] Encourage six small meals daily […] Encourage diet rich in fiber and low in cholesterol, calories, and saturated fats […] Promote rest periods between activities […] Adjust climate to a comfortable temperature for the individual […] Administer medications as ordered, in the morning or on an empty stomach […] Insert IV if admitted for monitoring […] Monitor heart rhythm […] Offer emotional support […] Provide meticulous skincare […] Seizure precautions […] Monitor lab results […] Monitor treatment response […] Expected Outcomes […] TSH levels return to normal […] States improved feeling of wellbeing

• #50 Hypothyroidism Nursing Diagnosis and Care Plans

  https://www.verywellhealth.com/hypothyroidism-nursing-diagnosis-5509321

  Following the nursing diagnosis, goals are created for nursing interventions with measurable outcomes to provide the best care. […] Nursing interventions are actions a nurse takes to improve someone’s health outcomes. […] Nursing interventions for patients with hypothyroidism may include: Educating the person and their family about hypothyroidism […] Nursing care plans contain information about a person’s diagnosis, treatment goals, nursing interventions, and potential outcomes. […] The nursing care plan aims to provide accessible, person-centered care and should include the following: Nursing diagnosis, Desired outcomes/goals, Nursing interventions and rationale. […] Nursing considerations for hypothyroidism include: Evaluating potential drug interactions of other medications the person is taking with thyroid hormone replacement therapy (levothyroxine)

• #51 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Effective treatment should achieve a clinical improvement of signs and symptoms, along with an improved sense of patient well-being and normal TSH or free T4 levels. […] Hypothyroidism affects multiple organ systems across all age groups and affects patient well-being and ability to function daily. Treatment is with levothyroxine monotherapy. […] Advise patients that treatment for hypothyroidism is lifelong. Instruct clients to take medications 30 to 60 minutes before the first meal of the day is essential. Also, inform patients not to take thyroid medications with other medications, as several food and medication interactions may occur.

• #52 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Decrease in symptoms […] Increased energy […] Individual/Caregiver Education […] Condition, treatment, and expected outcomes […] Notify healthcare provider or seek immediate medical care for: […] No improvement of symptoms […] Worsening of symptoms […] Palpitations or racing heart […] Change in behavior or mental status […] Slow breathing or shortness of breath […] Increased swelling of hands, feet, or face […] Increased appetite […] Insomnia […] Shakiness […] Weight changes and body requirements with hypothyroidism […] Thyroid hormones and compliance […] Not to stop taking the medication without contacting a healthcare provider […] Benefits, side effects, and interactions of medications […] Follow-up visits with a healthcare provider

• #53 Hypothyroidism (Underactive Thyroid): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism

  Youll need to take hypothyroidism medication for the rest of your life. With careful management and regular follow-ups with your healthcare provider, you can lead a normal and healthy life. […] Currently, theres no cure for hypothyroidism. But you can successfully manage the condition with hormone replacement therapy. […] People with hypothyroidism have a great outlook if they receive treatment. Left untreated, an underactive thyroid can cause life-threatening complications like myxedema. […] If you develop hypothyroidism symptoms like weight gain, dry skin or fatigue, let your healthcare provider know. They may want to run tests to rule out other conditions. […] Without treatment, hypothyroidism can become a serious and life-threatening medical condition.

• #54 Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289

  If you have coronary artery disease or severe hypothyroidism, your health care provider may start treatment with a smaller amount of medicine and then slowly increase the dosage. […] Levothyroxine is best taken on an empty stomach at the same time every day. […] Don’t skip doses or stop taking the medicine because you feel better. […] If you are diagnosed with subclinical hypothyroidism, talk about treatment with your health care provider.

• #55 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  In older adults, hypothyroidism may have a subtle or more nonspecific presentation. […] For older patients or those with coronary artery disease, levothyroxine therapy should be started at 25 to 50 mcg per day, with titration of 25 mcg every three to four weeks until a target dosage is achieved to decrease the potential for adverse effects from thyroid excess. […] Pregnancy is associated with increased levothyroxine requirements as early as the fourth week of gestation. […] Once pregnancy is confirmed, patients with existing hypothyroidism should start taking an extra dose of levothyroxine two days per week for a total of nine doses per week. […] Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications.

• #56 Special Populations

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/understanding-hypothyroidism-and-hyperthyroidism

  Hypothyroidism is a state of low circulating thyroid hormones. […] Hypothyroidism results in the slowing down of many physical and mental processes. Myxedema coma, the decompensated severe form of hypothyroidism, is a medical emergency that warrants immediate treatment with thyroid hormone and intensive care unit admission (Ross, 2024a). […] Thyroid replacement, using a form of T4 (levothyroxine sodium), is the preferred treatment that requires only once-a-day dosing. […] Patients should be monitored closely until stable. After TSH is stabilized, maintenance therapy should be continued with annual or semiannual TSH testing. Effective treatment should improve or resolve most signs and symptoms. […] Inform patient that thyroid replacement treatment will likely continue for life. […] Advise patient that medication should be taken at the same time each day on an empty stomach (at least one hour before other medications). […] Teach patient that reduced absorption can occur when taken with calcium, iron, vitamins, antacids, colestipol (or other medications that bind bile acids), and fiber supplements. […] Manage constipation with laxatives and dry skin with moisturizer. […] Signs and symptoms of hypothyroidism may be very subtle and mistakenly attributed to normal aging changes. […] Taking a careful history is important to make the correct diagnosis and helps to avoid erroneous diagnoses of heart failure, dementia, or depression.

• #57 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  In older adults, hypothyroidism may have a subtle or more nonspecific presentation. […] For older patients or those with coronary artery disease, levothyroxine therapy should be started at 25 to 50 mcg per day, with titration of 25 mcg every three to four weeks until a target dosage is achieved to decrease the potential for adverse effects from thyroid excess. […] Pregnancy is associated with increased levothyroxine requirements as early as the fourth week of gestation. […] Once pregnancy is confirmed, patients with existing hypothyroidism should start taking an extra dose of levothyroxine two days per week for a total of nine doses per week. […] Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications.

• #58 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  In older adults, hypothyroidism may have a subtle or more nonspecific presentation. […] For older patients or those with coronary artery disease, levothyroxine therapy should be started at 25 to 50 mcg per day, with titration of 25 mcg every three to four weeks until a target dosage is achieved to decrease the potential for adverse effects from thyroid excess. […] Pregnancy is associated with increased levothyroxine requirements as early as the fourth week of gestation. […] Once pregnancy is confirmed, patients with existing hypothyroidism should start taking an extra dose of levothyroxine two days per week for a total of nine doses per week. […] Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications.

• #59 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  A recent systematic review concluded that most non-pregnant individuals with subclinical hypothyroidism do not benefit from treatment. […] Age-specific local reference ranges for TSH should be considered when establishing a diagnosis of subclinical hypothyroidism, particularly in older people. […] Most elderly patients with subclinical hypothyroidism should be carefully followed up with a wait and see strategy, generally avoiding replacement therapy. […] The goals of therapy for hypothyroidism include: amelioration of hypothyroid symptoms, restoration of a euthyroid state, avoidance of overtreatment. […] Restoration of a euthyroid state can be readily accomplished in almost all patients by oral administration of LT4. […] The average full replacement dose of LT4 in adults is approximately 1.6 g/kg body weight per day.

• #60 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  A recent systematic review concluded that most non-pregnant individuals with subclinical hypothyroidism do not benefit from treatment. […] Age-specific local reference ranges for TSH should be considered when establishing a diagnosis of subclinical hypothyroidism, particularly in older people. […] Most elderly patients with subclinical hypothyroidism should be carefully followed up with a wait and see strategy, generally avoiding replacement therapy. […] The goals of therapy for hypothyroidism include: amelioration of hypothyroid symptoms, restoration of a euthyroid state, avoidance of overtreatment. […] Restoration of a euthyroid state can be readily accomplished in almost all patients by oral administration of LT4. […] The average full replacement dose of LT4 in adults is approximately 1.6 g/kg body weight per day.

• #61 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  In older adults, hypothyroidism may have a subtle or more nonspecific presentation. […] For older patients or those with coronary artery disease, levothyroxine therapy should be started at 25 to 50 mcg per day, with titration of 25 mcg every three to four weeks until a target dosage is achieved to decrease the potential for adverse effects from thyroid excess. […] Pregnancy is associated with increased levothyroxine requirements as early as the fourth week of gestation. […] Once pregnancy is confirmed, patients with existing hypothyroidism should start taking an extra dose of levothyroxine two days per week for a total of nine doses per week. […] Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications.

• #62 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes. […] Symptom relief and normalized thyroid-stimulating hormone levels are achieved with levothyroxine replacement therapy, started at 1.5 to 1.8 mcg per kg per day. Patients older than 60 years or with known or suspected ischemic heart disease should start at a lower dosage of levothyroxine (12.5 to 50 mcg per day). […] Women with hypothyroidism who become pregnant should increase their weekly dosage by 30% up to nine doses per week (i.e., take one extra dose twice per week), followed by monthly evaluation and management.

• #63 Thyroid disease: Long-term management of hyperthyroidism and hypothyroidism

  https://www1.racgp.org.au/ajgp/2021/january-february/thyroid-disease-long-term-management-of-hyperthyro

  Because co-administration of food with the medication can impair LT4 absorption, the medication should be taken while fasting at least 30 minutes and ideally 60 minutes before breakfast. […] Patients with overt hypothyroidism should generally have the LT4 dose adjusted to achieve a normal TSH level to avoid these potential adverse effects. […] Patients with hypothyroidism who are maintained on LT4 therapy should increase the dosage of their medication initially by approximately 25% as soon as pregnancy has been confirmed. […] Regular monitoring of serum TSH and FT4 levels is recommended, particularly during the first half of gestation, to adjust the LT4 dosage to maintain these parameters within the normal pregnancy reference range (0.12.5 mIU/L). […] The hypothyroid phase is usually transient; therefore, thyroxine replacement may not be required.

• #64 What Is Hypothyroidism? | American Association of Clinical Endocrinology

  https://www.aace.com/disease-and-conditions/thyroid/what-hypothyroidism

  An underactive thyroid, or hypothyroidism, occurs when the thyroid gland creates less than the normal amount of thyroid hormone. The result is the slowing down of many bodily functions. Hypothyroidism usually is a permanent condition that can be treated. […] Hypothyroidism is generally treated with a single daily dose of levothyroxine, given as a tablet. The correct dosage can help return the thyroid balance to normal. It is essential to take the medication as prescribed. […] Appropriate management of hypothyroidism requires continued care by a physician experienced in the treatment of this condition. […] It is important that women with hypothyroidism who plan to become pregnant keep their thyroid hormone levels well adjusted, since hypothyroidism can affect the development of the baby. During pregnancy, thyroid hormone replacement requirements often change, so more frequent monitoring is necessary.

• #65 Hypothyroidism (Underactive Thyroid) Symptoms, Diagnosis, and Treatment | Saint John’s Cancer Institute – Santa Monica, CA

  https://www.saintjohnscancer.org/endocrine/conditions/hypothyroidism/

  Hypothyroidism is what happens when your thyroid gland is not producing enough thyroid hormone and your body feels sluggish. […] An underactive thyroid is treated with thyroid replacement hormone, most commonly in the form of T4. Your dose of medication will be titrated based on your labs and hypothyroid symptoms. Most patients do very well and are stabilized on the correct dose of medication within a few months. […] Hypothyroidism during pregnancy needs to be treated and addressed to prevent complications such as: Congestive heart failure, Postpartum hemorrhage, Anemia, Pre-eclampsia in the mother, Low birth weight, Mild to severe congenital defects, Neonatal hypothyroidism in the fetus. […] Treatment during pregnancy is important and adjustment of medication is common as thyroid hormone requirements increase 25-50% during pregnancy.

• #66 Hypothyroidism and Joint Pain – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/hypothyroidism-and-joint-pain/

  Hypothyroidism is a clinical state in which thyroid hormone, which regulates the body, is depleted. Hypothyroidism causes the body to slow down and results in symptoms such as joint pain likely due to the effect of thyroid hormone on bone and cartilage proliferation and differentiation. Thus, hypothyroidism may lead to musculoskeletal conditions such as epiphyseal dysgenesis, septic necrosis, arthritis, crystal-induced arthritis, erosive osteoarthritis, arthralgias, muscle weakness, myalgias, carpal tunnel syndrome, and highly viscous, noninflammatory joint effusions in the knees, wrists, and hands. […] Hypothyroidism is typically treated with levothyroxine, a thyroid hormone. Most patients receive 1.6 mcg/kg per day, while elderly and atrial fibrillation patients may require lower doses.

• #67 Hypothyroidism and Joint Pain – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/hypothyroidism-and-joint-pain/

  Effective treatment should help improve all hypothyroidism symptoms. If a patient’s labs are normal while on thyroid replacement, but joint symptoms do not resolve, they likely are not due to hypothyroidism. […] Additionally, since autoimmune disorders tend to cluster, it is important to diagnose and treat each condition. For example, if the joint pain and tenderness are related to co-occurring RA, the RA should also be addressed.

• #68 Hypothyroidism and Joint Pain – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/hypothyroidism-and-joint-pain/

  Effective treatment should help improve all hypothyroidism symptoms. If a patient’s labs are normal while on thyroid replacement, but joint symptoms do not resolve, they likely are not due to hypothyroidism. […] Additionally, since autoimmune disorders tend to cluster, it is important to diagnose and treat each condition. For example, if the joint pain and tenderness are related to co-occurring RA, the RA should also be addressed.

• #69 Hypothyroidism (Underactive Thyroid): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism

  Youll need to take hypothyroidism medication for the rest of your life. With careful management and regular follow-ups with your healthcare provider, you can lead a normal and healthy life. […] Currently, theres no cure for hypothyroidism. But you can successfully manage the condition with hormone replacement therapy. […] People with hypothyroidism have a great outlook if they receive treatment. Left untreated, an underactive thyroid can cause life-threatening complications like myxedema. […] If you develop hypothyroidism symptoms like weight gain, dry skin or fatigue, let your healthcare provider know. They may want to run tests to rule out other conditions. […] Without treatment, hypothyroidism can become a serious and life-threatening medical condition.

• #70 Hypothyroidism (underactive thyroid) | healthdirect

  https://www.healthdirect.gov.au/hypothyroidism

  If your symptoms dont go away with thyroid hormone replacement therapy, it may be due to other health problems. Talk to your doctor if you arent feeling better. They may refer you to an endocrinologist. […] Hypothyroidism can lead to a range of health problems including: high cholesterol, decreased fertility, problems with thinking, depression, heart disease, a severe type of hypothyroidism called myxoedema coma this is very rare. […] Most types of hypothyroidism cant be prevented, but the symptoms can be managed.

• #71

  https://www2.hse.ie/conditions/underactive-thyroid-hypothyroidism/

  An underactive thyroid gland (hypothyroidism) means your thyroid gland is not producing enough hormones. […] An underactive thyroid can often be treated by taking hormone tablets. These are used to replace the hormones your thyroid is not making. […] Treatment for an underactive thyroid involves taking daily hormone replacement tablets. […] Levothyroxine tablets raise your thyroxine levels. […] You’ll have regular blood tests until the correct dose of levothyroxine is reached. […] You’ll usually need treatment for the rest of your life. But with proper treatment, you can lead a normal, healthy life. […] If an underactive thyroid is not treated, it can lead to complications. […] These can include: heart disease, goitre (an enlarged thyroid gland), pregnancy problems, myxoedema coma (a very rare but life-threatening condition).

• #72 Hypothyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html

  Adding T3 to levothyroxine does not additionally alleviate symptoms of hypothyroidism. […] Rarely, severe hypothyroidism can cause myxedema coma, a medical emergency most commonly found in older patients with primary hypothyroidism, with a 25% to 60% mortality rate. […] Subclinical hypothyroidism is common in patients 65 years and older. […] Most adults older than 30 years with elevated TSH but normal FT4 levels do not benefit from thyroid hormone therapy, and 60% normalize within five years. […] In nonpregnant patients with subclinical hypothyroidism, levothyroxine therapy should be considered when the TSH level is greater than 10 mIU per L or the TPO antibody level is elevated.

• #73 Med-Surg Nursing: Hypothyroidism & Myxedema Coma – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-14-hypothyroidism-myxedema-coma?srsltid=AfmBOoqDxizpCndzg6R4IdZqWDuOrmMhVtJlEJdzPJ3wVEan9N5nZChV

  In terms of nursing care for a patient who has hypothyroidism, you want to encourage frequent rest periods because they have this lethargy, you want to encourage a low-calorie, high-fiber diet to help promote weight loss and to prevent constipation, and then you want to increase the patient’s room temperature and provide blankets because they have this cold intolerance. […] The signs and symptoms of myxedema coma are very serious and include hypoxia (not enough oxygen), decreased cardiac output, decreased levels of consciousness (hence coma), bradycardia, hypotension and hypothermia.

• #74 Hypothyroidism – UF Health

  https://ufhealth.org/conditions-and-treatments/hypothyroidism

  Myxedema crisis is a medical emergency that must be treated in the hospital. Some people may need oxygen, breathing assistance (ventilator), fluid replacement, and intensive-care nursing. […] Contact your provider if you have symptoms of hypothyroidism. […] If you are being treated for hypothyroidism, call your provider if:

• #75 Hypothyroidism – UF Health

  https://ufhealth.org/conditions-and-treatments/hypothyroidism

  Myxedema crisis is a medical emergency that must be treated in the hospital. Some people may need oxygen, breathing assistance (ventilator), fluid replacement, and intensive-care nursing. […] Contact your provider if you have symptoms of hypothyroidism. […] If you are being treated for hypothyroidism, call your provider if:

• #76 Hypothyroidism Secondary – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/patient-resources/patient-education/endocrine-surgery-encyclopedia/hypothyroidism-secondary

  Life-long therapy may be necessary. […] Medication must be continued even when symptoms subside. […] In patients who have hypothyroidism caused by a pituitary tumor, surgery may be required. […] Myxedema coma is treated by intravenous (IV) thyroid replacement and steroid therapy. […] With early treatment, return to the normal state is usual. […] However, relapses will occur if the medication is not continued. […] Myxedema coma can result in death. […] Call your health care provider if signs of hypothyroidism are present, or if chest pain or rapid heartbeat occur.

• #77 Hypothyroidism Diet: Foods to Eat, Avoid, and Meal Plan Ideas

  https://www.healthline.com/nutrition/hypothyroidism-diet

  If you have hypothyroidism, you may benefit from eliminating gluten, processed foods, and any foods that may trigger your immune system or cause inflammation. […] Medication is the first line of treatment for hypothyroidism, but eating a balanced and nutritious may help reduce symptoms and support your overall health. […] For people with hypothyroidism, including Hashimotos thyroiditis, dietary interventions may have specific benefits, including: improving thyroid function, helping maintain a moderate body weight, reducing symptoms of hypothyroidism, reducing nutrient deficiencies, which may worsen symptoms. […] A diet low in pro-inflammatory foods, added sugar, and ultra-processed foods can be helpful for many people with hypothyroidism. Eating foods rich in particular nutrients may also support thyroid health.

• #78 Hypothyroidism Diet: Foods to Eat, Avoid, and Meal Plan Ideas

  https://www.healthline.com/nutrition/hypothyroidism-diet

  If you have hypothyroidism, you may benefit from eliminating gluten, processed foods, and any foods that may trigger your immune system or cause inflammation. […] Medication is the first line of treatment for hypothyroidism, but eating a balanced and nutritious may help reduce symptoms and support your overall health. […] For people with hypothyroidism, including Hashimotos thyroiditis, dietary interventions may have specific benefits, including: improving thyroid function, helping maintain a moderate body weight, reducing symptoms of hypothyroidism, reducing nutrient deficiencies, which may worsen symptoms. […] A diet low in pro-inflammatory foods, added sugar, and ultra-processed foods can be helpful for many people with hypothyroidism. Eating foods rich in particular nutrients may also support thyroid health.

• #79 Hypothyroidism Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/hypothyroidism

  Your health care provider will prescribe a synthetic thyroid hormone called levothyroxine (Levothroid, Synthroid, or Unithroid) that you will take daily. […] If you have hypothyroidism, you need conventional medical treatment. Nutrition and herbs can help support conventional treatment, but should not be used by themselves to treat hypothyroidism. […] Following these nutritional tips may help reduce symptoms: […] After you start on thyroid hormone replacement therapy, your provider will frequently monitor its effectiveness. […] Homeopathy may be useful as a supportive therapy. […] Acupuncture may be helpful in correcting hormonal imbalances, including thyroid disorders.

• #80 Hypothyroidism (myxedema) Nursing Care Plan and Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/hypothyroidism-myxedema/

  Hypothyroidism is a hypothyroid state resulting from a hyposecretion of the thyroid hormones T4 and T3. […] Hypothyroidism is characterized by decreased rate of body metabolism. […] Most patients are diagnosed and treated on an outpatient basis. The goal of treatment is to return the patient to the euthyroid (normal) state and to prevent complications. The treatment of choice is to provide thyroid hormone supplements to correct hormonal deficiencies. […] Treatment of the elderly patient is approached more cautiously because of higher risk for cardiac complications and toxic effects. […] The diet for the hypothyroid patient is generally low in calories, high in fiber, and high in protein. […] The primary goal of nursing care for a patient with hypothyroidism and decreased cardiac output due to bradycardia is to monitor and manage the patients cardiovascular status while providing thyroid hormone replacement therapy.

• #81 Hypothyroidism: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypothyroidism-nursing-diagnosis-care-plan/

  Hypothyroidism can disrupt sleep and cause insomnia. This exacerbates feelings of fatigue and causes excessive daytime sleepiness. […] Hypothyroidism causes various nonspecific symptoms that can affect the epidermis, dermis, hair and nails, and sweat glands. […] Hypothyroidism can slow lymphatic drainage causing fluid retention. […] Risk for imbalanced nutrition: less than body requirements associated with hypothyroidism can be caused by a thyroid hormone deficiency resulting in slow metabolism. […] A well-balanced diet and plenty of water are enough. A specific diet will not treat or prevent hypothyroidism.

• #82 Hypothyroidism: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypothyroidism-nursing-diagnosis-care-plan/

  Hypothyroidism can disrupt sleep and cause insomnia. This exacerbates feelings of fatigue and causes excessive daytime sleepiness. […] Hypothyroidism causes various nonspecific symptoms that can affect the epidermis, dermis, hair and nails, and sweat glands. […] Hypothyroidism can slow lymphatic drainage causing fluid retention. […] Risk for imbalanced nutrition: less than body requirements associated with hypothyroidism can be caused by a thyroid hormone deficiency resulting in slow metabolism. […] A well-balanced diet and plenty of water are enough. A specific diet will not treat or prevent hypothyroidism.

• #83 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Monitor for signs and symptoms of overtreatment with levothyroxine. Indications of overtreatment mimic signs and symptoms of hyperthyroidism, such as anxiety, palpitations, tachycardia, heat intolerance, fever, excessive sweating, changes in appetite, and weight loss. Report any signs of cardiac excitability, chest pain, and dysrhythmias to the medical provider.

• #84 Med-Surg Nursing: Hypothyroidism & Myxedema Coma – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-14-hypothyroidism-myxedema-coma?srsltid=AfmBOoqDxizpCndzg6R4IdZqWDuOrmMhVtJlEJdzPJ3wVEan9N5nZChV

  In terms of nursing care for a patient who has hypothyroidism, you want to encourage frequent rest periods because they have this lethargy, you want to encourage a low-calorie, high-fiber diet to help promote weight loss and to prevent constipation, and then you want to increase the patient’s room temperature and provide blankets because they have this cold intolerance. […] The signs and symptoms of myxedema coma are very serious and include hypoxia (not enough oxygen), decreased cardiac output, decreased levels of consciousness (hence coma), bradycardia, hypotension and hypothermia.

• #85

  https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/

  An underactive thyroid gland (hypothyroidism) is where your thyroid gland does not produce enough hormones. […] An underactive thyroid can often be successfully treated by taking daily hormone tablets to replace the hormones your thyroid is not making. […] Treatment for an underactive thyroid involves taking daily hormone replacement tablets, called levothyroxine, to raise your thyroxine levels. […] You’ll usually need treatment for the rest of your life. However, with proper treatment, you should be able to lead a normal, healthy life. […] If an underactive thyroid is not treated, it can lead to complications, including heart disease, goitre, pregnancy problems and a life-threatening condition called myxoedema coma (although this is very rare).

• #86 Hypothyroidism Treatment & Management: Approach Considerations, Hypothyroidism in Pregnancy, Subclinical Hypothyroidism

  https://emedicine.medscape.com/article/122393-treatment

  The treatment goals for hypothyroidism are to reverse clinical progression and correct metabolic derangements, as evidenced by normal blood levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4). Thyroid hormone is administered to supplement or replace endogenous production. In general, hypothyroidism can be adequately treated with a constant daily dose of levothyroxine (LT4). […] Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a TSH level within the reference range may take several months because of delayed readaptation of the hypothalamic-pituitary axis. In patients receiving treatment with LT4, dosing changes should be made every 4-6 weeks until the patients TSH is in target range. […] After dosage stabilization, patients can be monitored with annual or semiannual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of overtreatment, which include the following: Tachycardia, Palpitations, Atrial fibrillation, Nervousness, Tiredness, Headache, Increased excitability, Sleeplessness, Tremors, Possible angina.

• #87 Hypothyroidism | Endocrinology and Diabetes

  https://health.ucdavis.edu/conditions/hypothyroidism

  During routine physical exams, we check for signs of abnormal thyroid hormone levels. […] We test your blood for TSH or thyroid hormone at least once a year to ensure your levels are normal. We do more frequent blood tests early on in your treatment. As needed, we adjust your medication based on the results.

• #88 Hypothyroidism | Hashimoto’s Disease | MedlinePlus

  https://medlineplus.gov/hypothyroidism.html

  Hypothyroidism, or underactive thyroid, happens when your thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. […] The treatment for hypothyroidism is medicine to replace the hormone that your own thyroid can no longer make. About 6 to 8 weeks after you start taking the medicine, you will get a blood test to check your thyroid hormone level. Your health care provider will adjust your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you find the right dose, you will probably get a blood test in 6 months. After that, you will need the test once a year. […] If you take your medicine according to the instructions, you usually should be able to control the hypothyroidism. You should never stop taking your medicine without talking with your health care provider first.

• #89 Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics

  Levothyroxine should be taken once per day on an empty stomach (ideally one hour before eating or four hours after). Most people take their medication as soon as they wake in the morning and delay eating breakfast as long as practical before leaving for work or school. […] Most people with hypothyroidism require lifelong treatment, although the dose of levothyroxine may need to be adjusted over time. […] Changes in the levothyroxine dose usually are based upon your TSH level. Your dose may need to be increased if thyroid disease worsens, you get pregnant, gastrointestinal conditions impair levothyroxine absorption, or you gain weight. […] The decision to treat subclinical hypothyroidism with levothyroxine is controversial. We treat all patients with a TSH >7 to 10 mU/L. […] Some doctors treat hypothyroidism with liothyronine (T3) pills in addition to levothyroxine (T4). This is controversial because most studies have not found a benefit. However, this might be an option if your symptoms do not improve enough with levothyroxine alone.

• #90

  https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/

  An underactive thyroid gland (hypothyroidism) is where your thyroid gland does not produce enough hormones. […] An underactive thyroid can often be successfully treated by taking daily hormone tablets to replace the hormones your thyroid is not making. […] Treatment for an underactive thyroid involves taking daily hormone replacement tablets, called levothyroxine, to raise your thyroxine levels. […] You’ll usually need treatment for the rest of your life. However, with proper treatment, you should be able to lead a normal, healthy life. […] If an underactive thyroid is not treated, it can lead to complications, including heart disease, goitre, pregnancy problems and a life-threatening condition called myxoedema coma (although this is very rare).

• #91 Hypothyroidism (Underactive Thyroid): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism

  Youll need to take hypothyroidism medication for the rest of your life. With careful management and regular follow-ups with your healthcare provider, you can lead a normal and healthy life. […] Currently, theres no cure for hypothyroidism. But you can successfully manage the condition with hormone replacement therapy. […] People with hypothyroidism have a great outlook if they receive treatment. Left untreated, an underactive thyroid can cause life-threatening complications like myxedema. […] If you develop hypothyroidism symptoms like weight gain, dry skin or fatigue, let your healthcare provider know. They may want to run tests to rule out other conditions. […] Without treatment, hypothyroidism can become a serious and life-threatening medical condition.

• #92 Hypothyroidism Nursing Care Management and Study Guide

  https://nurseslabs.com/hypothyroidism/

  Learn about the nursing care management of patients with hypothyroidism in this nursing study guide. […] Nursing care for a patient with hypothyroidism includes the following: […] Assessment of the patient with hypothyroidism should include: […] Based on the assessment data, the nursing diagnoses appropriate for a patient with hypothyroidism are: […] To achieve a successful nursing care plan, the following goals should be realized: […] Nursing interventions for a patient with hypothyroidism include the following: […] A successful nursing care plan has achieved the following goals: […] At the completion of the home care instruction, the patient or caregiver will be able to: […] The focus of documentation should include:

• #93 Hypothyroidism (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568746/

  Nursing management plans for hypothyroidism include assessing the client’s weight and appetite, consulting with a dietitian to provide a menu for the patient, educating the patient and family, managing constipation with laxatives, encouraging the patient to use moisturizer if the skin is dry, educating the patient on compliance with thyroid hormone therapy, encouraging exercise, checking labs for levels of thyroid hormone, monitoring fluid intake, and encouraging the patient to follow up with a mental health nurse since depression is common in hypothyroidism. […] Monitor for signs and symptoms of overtreatment with levothyroxine. Indications of overtreatment mimic signs and symptoms of hyperthyroidism, such as anxiety, palpitations, tachycardia, heat intolerance, fever, excessive sweating, changes in appetite, and weight loss. Report any signs of cardiac excitability, chest pain, and dysrhythmias to the medical provider.

• #94 Hypothyroidism: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoo6uOYqmXN4XaWD6LG44YwkGirUyeH-QmfhidNB6ZZEIJYPZSNj

  Deficient knowledge: Disease process as evidenced by: (Phelps, 2021c): […] New disease process […] Lack of compliance with medication […] Interventions […] Monitor vital signs […] Encourage six small meals daily […] Encourage diet rich in fiber and low in cholesterol, calories, and saturated fats […] Promote rest periods between activities […] Adjust climate to a comfortable temperature for the individual […] Administer medications as ordered, in the morning or on an empty stomach […] Insert IV if admitted for monitoring […] Monitor heart rhythm […] Offer emotional support […] Provide meticulous skincare […] Seizure precautions […] Monitor lab results […] Monitor treatment response […] Expected Outcomes […] TSH levels return to normal […] States improved feeling of wellbeing

• #95 Hypothyroidism Nursing Care Plan Template & Example | Free PDF Download

  https://www.carepatron.com/templates/hypothyroidism-nursing-care-plan

  Early detection of subclinical hypothyroidism and consistent hormone monitoring is crucial for effective treatment. […] The care plan facilitates careful thyroid hormone replacement therapy monitoring, enabling timely adjustments to medication dosages based on patient response. […] The plan identifies key areas for educating patients about their condition and self-management strategies, empowering them to participate actively in their health. […] Caring for a patient with hypothyroidism involves administering prescribed thyroid hormone replacement medication and closely monitoring its effects on symptoms. […] Regular follow-up appointments are essential to assess thyroid hormone levels and adjust medication dosages as needed for optimal care. […] Goals for patients with hypothyroidism typically include achieving normal thyroid hormone levels, alleviating symptoms, preventing complications, and improving overall quality of life.

Zobacz więcej