Med Surg Exam 4 FINAL COPY Unit 9 Med-Surg NSG 3800 STUDY GUIDE LATEST 2020/2021

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Med Surg Exam 4 FINAL COPY Unit 9 Med-Surg NSG 3800 STUDY GUIDE Hypothyroid pg. 1513 Signs and symptoms: • Extreme Fatigue • Weight Gain • Cold Intolerance • Brittle Nails • Dry S... kin • Constipation: fiber, fluids, ambulation • Lifespan variances: Menorrhagia (excessive vaginal bleeding), Myxedema Coma (Severe Cases) Diagnosis • Elevated TSH • Fine needle aspiration • Radioactive iodine uptake test: meds that alter test (amiodarone, aspirin, Tagamet (GERD), valium, Lasix, lithium, phenytoin, propranolol) • Low T3 • Low T4 • Causes of Hypothyroidism Chart 52-3 pg. 1514 • Autoimmune • Thyroid gland can atrophy overtime (with age) • Meds (lithium, iodine compounds, anti-thyroid meds) • Radiation Medical management: hypothyroidism • Thyroid Replacement (Levothyroxine Sodium or Synthroid) • High-dose glucocorticoids (hydrocortisone) every 8 to 12 hours for 24 hours followed by low-dose therapy • If showing signs of Myxedema Coma, then switch to Synthroid • Take meds at same time each day • Avoid calcium consumption w/in 3 hours of taking meds • Monitor for cardiac issues due to high cholesterol • Meds don’t absorb as well w/ mag containing antacids, decreases effects of digoxin, if pt is on anticoagulants pt may need to decrease dose when starting levothyroxine b/c they are at an increased risk for bleeding w/ levothyroxine. Nursing Management: hypothyroidism • Physical Assessment • Pt teaching • Prevention of complications(myxedema coma) • Patients with hypothyroidism need to be monitored closely if ever given analgesics, sedatives, or anesthetic agents because the effects are prolonged • Older patients are at increased risk because of age-related changes in liver and renal function • Oral and written instructions need to be given to the patient and family regarding self-care • correct med admin “take first thing in the morning with a full glass of water” • continue taking even if symptoms improve [Show More]

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