Materiały źródłowe

• #1 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.

• #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 | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/hypothyroidism

  Hypothyroidism occurs when the thyroid gland fails to produce enough thyroid hormone. Without enough thyroid hormone, the body becomes tired and run down. Every organ system slows, including the brain, which affects concentration; the gut, causing constipation; and metabolism the rate at which the body burns energy resulting in weight gain. […] UCSF offers comprehensive consultations and care for thyroid conditions, including hypothyroidism (underactive thyroid). For this condition, we prescribe thyroid hormone and adjust the dose until normal levels are reached. With proper treatment, patients with hypothyroidism can eliminate symptoms. […] Since patients with hypothyroidism have deficient levels of thyroid hormone, treatment for the condition focuses on hormone replacement therapy. One example of hormone replacement treatment is the hormone pill levothyroxine, which is taken once a day, preferably in the morning.

• #4 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. […] Treatment for hypothyroidism usually includes taking the thyroid hormone medicine levothyroxine (Levo-T, Synthroid, others) every day. This medicine is taken by mouth. It returns hormone levels to a healthy range, eliminating symptoms of hypothyroidism. […] Levothyroxine is best taken on an empty stomach at the same time every day. Ideally, you take the hormone in the morning, and then wait 30 to 60 minutes before you eat or take other medicine. […] If you are diagnosed with subclinical hypothyroidism, talk about treatment with your health care provider. […] Most health care providers recommend taking the medicine levothyroxine to treat hypothyroidism.

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

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

  Hypothyroidism is when your thyroid gland doesnt make and release enough hormone into your bloodstream. The condition slows down your metabolism, which may make you gain weight unexpectedly or feel tired all the time. Hormone replacement therapy is the most common treatment for an underactive thyroid. […] In general, hypothyroidism is very treatable. Most people can manage the condition with medication and regular follow-up visits with their endocrinologist. […] The most common hypothyroidism treatment is hormone replacement therapy. Levothyroxine (Synthroid, Levo-T) is a medication that replaces the hormones that your thyroid cant make naturally. Most people take it in the morning on an empty stomach. Taken daily, levothyroxine can even out your hormone levels and eliminate your symptoms.

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

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-14-hypothyroidism-myxedema-coma?srsltid=AfmBOorwk3tLD3NeD4RVggZv7XBKojbE7qYVCmxLuGILJDkNJAh-HBoy

  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.

• #7 Thyroid – Hashimoto’s disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/thyroid-hashimotos-disease

  Hashimotos disease is a common cause of hypothyroidism (underactive thyroid). […] Treatment includes hormone replacement therapy with synthetic thyroid hormone (thyroxine), and the prognosis is usually excellent. […] Hypothyroidism means the thyroid gland is sluggish or underactive. […] Hashimotos disease is considered to be an autoimmune disease. […] The thyroid gland makes chemicals called hormones that regulate many metabolic processes, including growth and the rate at which your body burns up energy. […] The immune system creates antibodies that attack thyroid tissue. […] The thyroid gland becomes inflamed (thyroiditis) and thyroid cells become permanently damaged, which hampers the thyroids ability to make T4 and T3. […] With treatment, the outlook for most people with Hashimotos disease is excellent. Treatment usually includes medication with the synthetic thyroid hormone (thyroxine). […] You will need to take the medication for life. Medication does not cure the condition, but helps maintain normal thyroid hormone levels. […] The symptoms will return if thyroid medication is stopped.

• #8 Hypothyroidism and nursing care – American Nurse Today

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

  Hypothyroidism, also known as myxedema, is second to diabetes mellitus as the most common endocrine disorder in the United States. […] About 10% of women over age 60 have subclinical hypothyroidism. […] This article reviews the pathophysiology of hypothyroidism, as well as its causes, symptoms, diagnosis, treatment, and nursing care. […] The most common cause of hypothyroidism is autoimmune thyroiditis, or Hashimotos thyroiditis; damage to the thyroid through surgery, ablation, or radiation treatment are less common causes. […] Hypothyroidism can masquerade as vitamin B12 or D deficiency, iron deficiency, chronic kidney disease, obstructive sleep apnea, or viral infections, such as mononucleosis. […] Hypothyroidism is treated with synthetic T4 (levothyroxine), which is available in tablet, soft gel, and liquid form, although tablet is the most common.

• #9 Nursing Care and Pathophysiology for Hypothyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/hypothyroidism?parentId=217441

  There is a reduction in thyroid hormone secretion. This is caused by an autoimmune disorder attacking the thyroid and causing this reduction. […] Hypothyroidism is a condition of decreased secretion of thyroid hormones, so we’ll see decreased levels of T3, T4, and Free T4 in the blood. We’ll also see increased levels of TSH, or Thyroid Stimulating Hormone. […] When we’re managing hypothyroid patients, we can do a radionuclide scan with radioactive iodine and we’ll see decreased uptake. […] If they are hypothyroid and we see decreased uptake, decreased thyroid hormone levels, increased TSH levels, we’ll put them on hormone replacement therapy with levothyroxine or Synthroid. […] Our priority nursing concepts for patients with hypothyroidism are going to be hormone regulation, thermoregulation, and nutrition. […] We want to give levothyroxine to increase their hormone levels and monitor those levels closely so we can prevent the risk of Myxedema Coma or Thyroid Storm.

• #10 Older Patients and Thyroid Disease | American Thyroid Association

  https://www.thyroid.org/thyroid-disease-older-patient/

  Hypothyroidism is very common in patients over 60 years of age and steadily increases with age. Up to 1 in 4 patients in nursing homes may have undiagnosed hypothyroidism. Unlike symptoms of hyperthyroidism, the symptoms of hypothyroidism are very non-specific in all patients, even more so in the older patient. As with hyperthyroidism, the frequency of multiple symptoms decreases in the older patient. For example, memory loss or a decrease in cognitive functioning, often attributed to advancing age, may be the only symptoms of hypothyroidism present. Symptoms and signs of hypothyroidism may include weight gain, sleepiness, dry skin, and constipation, but lack of these symptoms does not rule out the diagnosis. To make this diagnosis in the elderly patient, a doctor often needs a high index of suspicion. Clues to the possibility of hypothyroidism include a positive family history of thyroid disease, past treatment for hyperthyroidism, or a history of extensive surgery and/or radiotherapy to the neck.

• #11 Hypothyroidism Nursing Diagnosis and Care Plans

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

  Hypothyroidism, or underactive thyroid, occurs when the thyroid gland does not produce enough thyroid hormone to meet the bodys needs. […] Because hypothyroidism is a chronic disease, a multidisciplinary approach is required to provide lifelong care and treatment. Nurses play a vital role in the care of people with hypothyroidism. […] A nursing assessment is an essential step in getting appropriate care for hypothyroidism. […] This assessment helps identify a person’s current and future needs. The information gathered is evaluated to help provide an accurate diagnosis and create a personalized treatment plan. […] A nursing diagnosis is a nurse’s clinical judgment of hypothyroidism’s impact on a person’s life. […] A nursing diagnosis, however, focuses on the physical, mental, spiritual, or psychosocial aspects of hypothyroidism; it examines the overall holistic care of a person with hypothyroidism based on their response to the condition and how it affects their day-to-day life.

• #12 6 Hypothyroidism (Myxedema) Nursing Care Plans

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

  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. […] Patients with hypothyroidism often require lifelong medication management and lifestyle changes. The complexity of this chronic condition, coupled with potential cognitive effects such as fatigue and brain fog, can lead to a lack of knowledge regarding disease management and self-care. Therefore, nursing care plans for hypothyroidism patients should prioritize patient education to ensure they have a thorough understanding of their condition and treatment plan.

• #13 Hypothyroidism – familydoctor.org

  https://familydoctor.org/condition/hypothyroidism/

  Hypothyroidism is known as underactive thyroid. It occurs when your thyroid gland does not make enough thyroid hormone. It means you have low thyroid activity. The thyroid gland is shaped like a butterfly. It is located in the front of your neck, below your Adam’s apple. The thyroid controls your metabolism. It makes hormones that control how well you burn calories, your heart rate, your muscles, bones, and other organs. […] Hypothyroidism often begins slowly. Symptoms can be mistaken for stress, depression, or other health problems. Common symptoms include: Fatigue. Unplanned weight gain. Muscle weakness. Muscle aches, cramps, tenderness, or stiffness. Increased sensitivity to cold. Constipation. Pale, dry skin. Puffy face. Hoarse voice. Joint pain, stiffness, or swelling. Changes in menstrual patterns, such as heavier flow. An enlarged thyroid gland (called a goiter), which can appear as swelling at the base of the neck. Brittle hair and fingernails. Forgetfulness or confusion.

• #14 How to Combat Dry Skin from Hypothyroidism

  https://npthyroid.com/tipsresource/combat-dry-skin-from-hypothyroidism/

  Hypothyroidism is characterized by an underactive thyroid gland. This gland is responsible for regulating the body’s metabolism, including the production and turnover of skin cells. […] When the thyroid hormone isn’t performing well, the skin may become flaky, dry, and itchy. […] To combat dry skin caused by hypothyroidism, it is important to first address the underlying thyroid issues. Consult with a health care professional who can diagnose and provide appropriate treatment options, such as thyroid hormone replacement therapy. […] For individuals with underactive thyroid function, skin care products being used, everyday behaviors, and even the weather can exacerbate already compromised skin. […] When combatting dry skin caused by hypothyroidism, it’s important to be mindful of the body care products you use.

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

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoqEd9PLVYb4PZGhZExr30VJR8LME8tzYVEwA9ShUiopyVs-6M9l

  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

• #16 Hypothyroidism and Joint Pain – Rheumatology Advisor

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

  Hypothyroidism occurs when this hormone is in short supply, which causes body processes to slow down, resulting in a constellation of symptoms, including joint pain. […] Hypothyroid arthropathy, a joint disease that includes arthritis, most commonly strikes the knees and hands in adults and the hip and the epiphysis of the femoral head in children. […] The link between hypothyroidism and joint pain appears to be bi-directional. […] Specifically, people with autoimmune hypothyroid disease are at risk for: Chronic, widespread pain, Fibromyalgia, Degenerative joint disease, Osteoarthritis, Seronegative inflammatory arthritis. […] With treatment, most patients with hypothyroidism and joint pain have a good prognosis, and symptoms usually resolve in a few weeks or months. […] Hypothyroidism is typically treated with levothyroxine, a thyroid hormone.

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

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoqEd9PLVYb4PZGhZExr30VJR8LME8tzYVEwA9ShUiopyVs-6M9l

  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

• #18 Thyroid conditions during pregnancy | March of Dimes

  https://www.marchofdimes.org/find-support/topics/pregnancy/thyroid-conditions-during-pregnancy

  Hypothyroidism (hypo means too little or not enough). This happens when the thyroid is underactive and makes too little thyroid hormones, so many of your body’s functions slow down. Hypothyroidism during pregnancy usually is caused by an autoimmune disorder called Hashimoto’s disease. When you have Hashimoto’s disease, your immune system makes antibodies that attack your thyroid and damage it so it can’t produce thyroid hormones. […] Signs of hypothyroidism (underactive thyroid) include: Dry skin or dry, thinning hair. Goiter. High cholesterol. Hoarse or husky voice. Slow heart rate. Sweating less. Weight gain and puffy face. […] Symptoms of hypothyroidism include: Being more sensitive to cold. Constipation. Depression. Fatigue (being really tired). Muscle and joint pain or stiffness, weak muscles, or muscle cramps. Problems with memory or problems being able to focus or pay attention. Problems with menstrual periods or with fertility (being able to get pregnant).

• #19 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. […] 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.

• #20 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

  Evidence based nursing care guidelines of adult patients with Hypothyroidism […] 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. […] 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.

• #21 Congenital Hypothyroidism (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/congenital-hypothyroidism.html

  Hypothyroidism (or underactive thyroid) is when the thyroid gland doesn’t make enough thyroid hormone. Low thyroid hormones make the body use up energy more slowly, and chemical activity (metabolism) in the cells slows down. […] A child with hypothyroidism will take thyroid hormone to make up for what the thyroid gland can’t make. Most kids need to take the medicine for the rest of their lives. […] If your child has hypothyroidism, it’s very important to give the thyroid hormone as instructed by your doctor. […] Your doctor will see your child regularly to make sure that the medicine is working and change the dose as your child grows. Be sure to go to all follow-up doctor visits.

• #22 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:

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

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-14-hypothyroidism-myxedema-coma?srsltid=AfmBOorwk3tLD3NeD4RVggZv7XBKojbE7qYVCmxLuGILJDkNJAh-HBoy

  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.

• #24 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: Perform assessments to identify signs and symptoms of hypothyroidism. Administer prescribed thyroid hormone replacement medications to patients. Monitor patients response to medication therapy. Educate patients about the importance of medication adherence and potential side effects. Assess and manage symptoms associated with hypothyroidism, such as fatigue, weight gain, and cold intolerance.

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

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoqEd9PLVYb4PZGhZExr30VJR8LME8tzYVEwA9ShUiopyVs-6M9l

  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

• #26 6 Hypothyroidism (Myxedema) Nursing Care Plans

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

  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 identify the basis of fatigue and individual areas of control. The client will verbalize a reduction of fatigue and increased ability to complete desired activities. […] Therapeutic interventions and nursing actions for patients with hypothyroidism may include: Assess the clients weight. Due to excess fluid volume and low basal metabolic rate, clients with hypothyroidism experience weight gain and difficulty losing extra weight. Assess the clients appetite. Clients with hypothyroidism have decreased appetite. This opposite relationship between weight gain and decreased appetite is a manifestation finding in hypothyroidism. Provide a food diary to the client. Looking into the clients food intake over the 24 hours will provide baseline data for an individualized nutritional plan for the clients changing metabolic needs. Educate the client and family regarding body weight changes in hypothyroidism. Teaching the client and family will make them understand the opposite relationship between appetite and weight gain in hypothyroidism. During the start of thyroid hormone replacement therapy, the client can experience loss of weight. However, there will be an increase in appetite. This change may require a calorie-controlled diet to prevent additional weight gain.

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

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

  Hypothyroidism is when the thyroid gland is underactive and does not produce enough hormones. […] Nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Deficient knowledge associated with hypothyroidism is related to insufficient knowledge of the condition and its signs and symptoms. […] Nursing Diagnosis: Deficient Knowledge […] Expected outcomes: Patient will be able to verbalize understanding of hypothyroidism and its signs and symptoms. […] Patient participation engages the patient in decision-making or expressing ideas regarding various treatment modalities, which involves sharing information, emotions, and physical symptoms and receiving advice from the nurse and other healthcare team members. […] Hypothyroidism can disrupt sleep and cause insomnia. […] Levothyroxine is effective at diminishing the symptoms of hypothyroidism. […] Administer IV levothyroxine. […] A well-balanced diet and plenty of water are enough. A specific diet will not treat or prevent hypothyroidism.

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

  https://www.ncbi.nlm.nih.gov/sites/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. […] 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.

• #29 Hypothyroidism and nursing care – American Nurse Today

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

  Teach patients about the many drug interactions with levothyroxine and about the importance of establishing a daily routine to help maintain even hormone levels. […] After beginning levothyroxine, symptom improvement can take up to 6 weeks, and dosing may need to be titrated, which is usually done at 3- to 6-week intervals. […] You suggest to Ms. Reynolds provider that perhaps she has hypothyroidism. TSH and T4 levels are ordered, and your suspicions are confirmedher TSH is 7.5 mlU/L and her T4 level is 3.9 mcg/dL. Levothyroxine is ordered.

• #30

  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. […] 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.

• #31 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.

• #32 How to Combat Dry Skin from Hypothyroidism

  https://npthyroid.com/tipsresource/combat-dry-skin-from-hypothyroidism/

  After showering, gently pat your skin dry with a towel, leaving it slightly damp. Then, apply a generous amount of moisturizer all over your body. […] Daily moisturizing will help keep your skin hydrated and minimize dryness and itchiness. […] Remember to consult with your health care professional if you have any concerns or if your symptoms persist.

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

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

  Patient education: 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.

• #34 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.

• #35 Older Patients and Thyroid Disease | American Thyroid Association

  https://www.thyroid.org/thyroid-disease-older-patient/

  A decision to treat the patient with a new diagnosis of hypothyroidism will rest on several factors, including whether the patient is symptomatic from hypothyroidism, or just has an elevated thyroid-stimulating hormone (TSH) level. In the case of the latter finding, many doctors will repeat the test in 3-4 months and elect to begin thyroid hormone replacement when the TSH level stays above the normal range. The presence or absence, and severity, of thyroid-related symptoms and co-existing diseases such as coronary artery disease or heart failure will determine the dose of thyroid hormone replacement that is given. […] As with the younger patient, pure synthetic thyroxine (L-T4), taken once daily by mouth, fully replaces the function of the thyroid gland and successfully treats the symptoms of hypothyroidism in most patients. In particular, treatment of the older hypothyroid patient must take into account that full thyroid hormone replacement need not take place rapidly, and in fact may put stress on the heart and central nervous system if accomplished too quickly. Rather, hormone treatment is usually begun slowly with a partial daily dose, in order to allow the heart and central nervous system to adjust to increasing levels of thyroid hormone. The patient and family members must be aware of a possible increase in angina, shortness of breath, confusion and change in sleep habits, and notify the prescribing physician if these occur.

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

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

  Your health care provider will prescribe an initial dose of levothyroxine and then retest your blood level of TSH after six weeks. Your dose can be adjusted at that time if needed. This process may need to be repeated several times before your hormone levels become normal. […] 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. […] Never increase or decrease the levothyroxine dose without talking with your health care provider. Over-replacement of T4 can cause mild hyperthyroidism, with the associated risks of atrial fibrillation (irregular heartbeat) and, possibly, accelerated bone loss (osteoporosis).

• #37 Hypothyroidism | Endocrinology and Diabetes

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

  During routine physical exams, we check for signs of abnormal thyroid hormone levels. Signs such as an enlarged thyroid gland or changes to your movement may mean we need to adjust your medication. […] 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.

• #38 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

  Evaluation of the effectiveness of drug therapy is an important task for nurses in order to confirm that patient goals and expected outcomes have been met. These outcomes include the patient’s Thyroid hormone levels are normal, the patient demonstrates decreased symptoms of hypothyroidism, the patient is free from significant adverse effects from drug therapy. And the patient demonstrates an understanding of the drug’s action by accurately describing drug side effects and precautions.

• #39

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2277

  You have hypothyroidism, which means that your body is not making enough thyroid hormone. This hormone helps your body use energy. If your thyroid level is low, you may feel tired, be constipated, have an increase in your blood pressure, or have dry skin or memory problems. You may also get cold easily, even when it is warm. Women with low thyroid levels may have heavy menstrual periods. […] The treatment for hypothyroidism is to take thyroid hormone pills. You should start to feel better in 1 to 2 weeks. But it can take several months to see changes in the TSH level. You will need regular visits with your doctor to make sure you have the right dose of medicine. […] Most people need treatment for the rest of their lives. You will need to see your doctor regularly to have blood tests and to make sure you are doing well.

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

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

  Individual levothyroxine doses can vary widely and depend upon a variety of factors, including the underlying cause of hypothyroidism. People with certain conditions require more frequent monitoring. […] People often need higher doses of levothyroxine during pregnancy. Testing is usually recommended every four weeks, beginning after conception, until levels are stable, then once each trimester. After giving birth, the woman’s dose of levothyroxine will need to be adjusted again, usually returning to the pre-pregnancy dose. […] Hypothyroidism can increase the risk of certain surgery-related complications; bowel function may be slow to recover, and infection may be overlooked if there is no fever. […] If you are scheduled for a non-emergency surgical procedure and your preoperative blood tests reveal overt hypothyroidism (high TSH, low T4), your procedure will likely be postponed until treatment has returned T4 levels to normal.

• #41 Thyroid conditions during pregnancy | March of Dimes

  https://www.marchofdimes.org/find-support/topics/pregnancy/thyroid-conditions-during-pregnancy

  Untreated hypothyroidism during pregnancy is linked to: Anemia. This is when you don’t have enough healthy red blood cells to carry oxygen to the rest of your body. Gestational hypertension. This is high blood pressure that starts after 20 weeks of pregnancy and goes away after you give birth. Preeclampsia. Placental abruption. Postpartum hemorrhage (also called PPH). This is when a woman has heavy bleeding after giving birth. Myxedema, a rare condition caused by severe, untreated hypothyroidism. Heart failure. […] Problems for babies can include: Infantile myxedema, a condition that’s linked to severe hypothyroidism that can cause dwarfism, intellectual disabilities, and other problems. Low birthweight. Problems with growth and brain and nervous system development. Thyroid problems. This is rare, but it can happen in babies of women with Hashimoto’s disease because the antibodies can cross the placenta during pregnancy. Miscarriage or stillbirth.

• #42 Thyroid conditions during pregnancy | March of Dimes

  https://www.marchofdimes.org/find-support/topics/pregnancy/thyroid-conditions-during-pregnancy

  Treating hypothyroidism. If you have hypothyroidism, your healthcare provider may recommend treatment to help manage your thyroid hormone levels during pregnancy. Some medications may be used to replace thyroid hormones that your body isn’t making enough. If you were already taking medicine for hypothyroidism before pregnancy, your provider may need to adjust your dose to make sure your thyroid levels stay within a healthy range. Regular blood tests during pregnancy can help monitor these levels. If you are breastfeeding, speak with your provider to understand what medicine is best to treat hypothyroidism.

• #43 Hypothyroidism: A Simple Guide to Navigating Thyroid Health | Cooper University Health Care

  https://www.cooperhealth.org/thyroid-disease/hypothyroidism

  Women diagnosed with hypothyroidism, who have symptoms, or who have a family history of the condition should have a TSH test when they find out they are pregnant. Pregnant women with an underactive thyroid will have their hormone levels monitored more frequently during their pregnancy to see if any adjustment is needed to their hormone replacement medication.

• #44 Hypothyroidism Secondary – Endocrine Surgery | UCLA Health

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

  Secondary hypothyroidism involves decreased activity of the thyroid caused by failure of the pituitary gland. […] The cause of secondary hypothyroidism is failure of the pituitary gland to secrete thyroid stimulating hormone (TSH). […] Hypothyroidism may cause a variety of symptoms and can affect all body functions. […] The body’s normal rate of functioning slows, causing mental and physical sluggishness. […] Symptoms vary from mild to severe. […] The most severe form is called myxedema, which is a medical emergency and can lead to coma and death. […] Risk factors for secondary hypothyroidism include being over 50 years old, being female, and having a history of pituitary or hypothalamic dysfunction. […] The purpose of treatment is to replace the deficient thyroid hormone. […] Levothyroxine is the most commonly used medication.

• #45 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. […] Supportive therapy of oxygen, assisted ventilation, fluid replacement, and intensive care nursing may be indicated. […] 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.

• #46 Hypothyroidism: Diagnosis and Treatment | AAFP

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

  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. […] 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. […] Clinical features include hypothermia and mental status changes (e.g., lethargy, confusion, psychosis), hypotension, bradycardia, hypoventilation, and diffuse nonpitting edema.

• #47 Older Patients and Thyroid Disease | American Thyroid Association

  https://www.thyroid.org/thyroid-disease-older-patient/

  Treatment may therefore begin with L-T4 in a dose of 25 to 50 micrograms daily, and the dose increased in steps every 4-6 weeks until the laboratory tests show a gradual return of blood thyroid hormone and thyroid-stimulating hormone (TSH) levels to the normal range. Older patients with no evidence of heart disease, stroke or dementia may be started on larger doses (for example, half of the anticipated full replacement dose) and proceed to full hormone replacement more quickly. In patients who experience increased angina pectoris, symptoms of congestive heart failure, or mental changes such as confusion will need to have their dose of L-T4 decreased, then more gradually increased over several months time. […] Thyroid disorders have no age limits; indeed, hypothyroidism is clearly more common in older than in younger adults. Despite the increased frequency of thyroid problems in older individuals, physicians need a high index of suspicion to make the diagnosis since thyroid disorders often manifest as a disorder of another system in the body. Older patients with thyroid disorders require special attention to gradual and careful treatment, and, as always, require lifelong follow-up.

• #48 Special Populations

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

  Thyroid replacement, using a form of T4 (levothyroxine sodium), is the preferred treatment that requires only once-a-day dosing. Thyroid replacement should be tailored for each patient, as small changes in dose can quickly cause an imbalance. 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. […] 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.

• #49 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

  The goals of therapy for hypothyroidism include: amelioration of hypothyroid symptoms, restoration of a euthyroid state, avoidance of overtreatment. […] 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 who commence LT4 therapy for symptoms attributed to subclinical hypothyroidism should be reviewed after three or four months to assess response to treatment once the serum TSH returns to the reference range. If symptoms have not improved then LT4 therapy should generally be discontinued and the patient reviewed for other disorders. […] The adverse effects of thyroid hormone deficiency are often nonspecific and may include cognitive impairment, hyperlipidaemia and progression of cardiovascular disease. Patients with overt hypothyroidism should generally have the LT4 dose adjusted to achieve a normal TSH level to avoid these potential adverse effects.

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

  https://www.nurse.com/clinical-guides/hypothyroidism/?srsltid=AfmBOoqEd9PLVYb4PZGhZExr30VJR8LME8tzYVEwA9ShUiopyVs-6M9l

  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

• #51 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

  Evaluation of the effectiveness of drug therapy is an important task for nurses in order to confirm that patient goals and expected outcomes have been met. These outcomes include the patient’s Thyroid hormone levels are normal, the patient demonstrates decreased symptoms of hypothyroidism, the patient is free from significant adverse effects from drug therapy. And the patient demonstrates an understanding of the drug’s action by accurately describing drug side effects and precautions.

• #52

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2277

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your thyroid hormone medicine exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. Most people do not have side effects if they take the right amount of medicine regularly. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

• #53 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. […] 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.

• #54 Hypothyroidism Nursing Diagnosis and Care Plans

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

  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. […] Nursing considerations for hypothyroidism include: Evaluating potential drug interactions of other medications the person is taking with thyroid hormone replacement therapy (levothyroxine) […] Hypothyroidism is a common condition requiring a multidisciplinary approach to care and lifelong treatment for most people. […] Person-centered plans are developed to focus on specific symptoms a person with hypothyroidism is experiencing, such as fatigue or weight gain, and provide nursing interventions to improve their overall health and well-being.

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

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

  With careful management and regular follow-ups with your healthcare provider, you can lead a normal and healthy life. […] You cant prevent hypothyroidism. If you develop symptoms like the ones mentioned above, let your healthcare provider know right away. Early diagnosis and treatment are the best ways to reduce your risk of complications and live a 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.

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