 They help regulate growth and the rate of chemical reactions (metabolism) in the body.  Thyroid hormones also help children grow and develop.

 A hyperthyroid state characterized by increased circulating T3 and T4  Thyrotoxicosis  Refers to the physiologic effects or clinical syndrome of hypermetabolism  Most common cause of hyperthyroidism is Graves disease, also called toxic diffuse goiter

 Nervous excitability  Highly irritable, emotionally unstable, and have attacks of anxiety

 Serum thyroid stimulating hormone normal to 6.15 uU/ml  Serum T3 normal – ng/dL  Radioactive Iodine Uptake test

 Autoimmune disorder in which antibodies are made and attach to the TSH receptor sites on the thyroid tissue.  Has thyrotoxicosis, goiter, exopthalmos, pretibial myxedema  Note: Not all patients with a goiter have hyperthyroidism  Other causes of hyperthyroid state: toxic nodular goiter, thyroid replacement hormones

 Or thyroid crisis  Exacerbations of symptoms of a preexisting hyperthyroid state Manifestations:  Hyperprexia  Extreme tachycardia  Delirium, convulsions  Hypovolemia/ electrolyte imbalance  Cardiac arrythmias

 Monitoring of patients  Reducing stimulations  Provide a HIGH-calorie diet, HIGH protein  Manage diarrhea

 Administer: a. anti-thyroid medications such as Methimazole and PTU b. IODINE preparation- Lugol’s solution and SSKI c.PROPRANOLOL  Prepare clients for Radioactive iodine therapy

 Prepare patient for thyroidectomythyroidectomy  Manage thyroid storm appropriately

HYPOsecretion: HYPOTHYROIDISM  A hypothyroid state characterized by decreased secretions of T3 and T4  CAUSES: Auto immune thyroiditis, iodine deficiency, antithyroid medications, thyroidectomy, Pituitary tumor, problems with the hypothalamus

 Characteristic swelling around the eyes, lips and fingers  Exaggerated symptoms of hypothyroidism  Ability to adjust to cold environment is compromised

 manifestation hypothermia, respiratory drive is depressed, progressive carbon dioxide retention and coma Myxedema coma – rare, serious complication of untreated or poorly treated hypothyroidism

 Hypothyroidism that develop in infancy is termed as cretinism

1. Monitor VS especially HR 2. Administer hormone replacement: usually Levothyroxine( Synthroid) 3. Instruct patient to eat LOW calorie, LOW cholesterol and LOW fat diet 4. Manage constipation appropriately

5. Provide a WARM environment 6. Avoid sedatives and narcotics 7. Instruct patient to report chest pain promptly

THYROIDECTOMY  Removal of the thyroid gland

 Obtain VS and weight  Assess for Electrolyte levels, glucose levels and T3/T4 levels  Provide pre-operative teaching like coughing and deep breathing, early ambulation and support of the neck when moving  Administer prescribed medications- Lugol’s to decrease size

 Position patient: Semi-Fowler’s, neck on neutral position  Check for edema and bleeding by noting the dressing anteriorly and at the back of the neck  Monitor for respiratory distress- apparatus at bedside- tracheostomy set, O2 tank and suction machine!

HOARSENESS  Assess for HOARSENESS  If persistent, may indicate damage to laryngeal nerve!  Monitor for signs of hypocalcemia and tetany due to trauma of the parathyroid gland  Prepare Calcium gluconate  Monitor for thyroid stormthyroid storm  Less common