cholesterol and triglycerides anemia Collaborative Care Restoration of

Cholesterol and triglycerides anemia collaborative

  • Towson University
  • NURS 360
  • Notes
  • zwasse2
  • 14
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↑ cholesterol and triglycerides, anemia Collaborative Care Restoration of euthyroid state as safely and rapidly as possible Low-calorie diet Drug therapy (education required) Patient/family teaching Outcome Goals Experience relief of symptoms Maintain a euthyroid state Maintain a positive self-image Comply with lifelong thyroid replacement therapy Thyroid Preparations levothyroxine (Synthroid, Levothyroid) o Synthetic thyroid hormone T 4 liothyronine (Cytomel)- Synthetic thyroid hormone T 3 9
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Lecture Notes liotrix (Thyrolar)- Synthetic thyroid hormone T 3 and T 4 combined Thyroid- Desiccated (dried) animal thyroid gland Indications To treat all three forms of hypothyroidism Levothyroxine is the preferred drug because its hormonal content is standardized; therefore, its effect is predictable o Stay on ONE BRAND ALWAYS “Euthyroid” is the goal Adverse Effects Cardiac dysrhythmia is the most significant adverse effect May also cause hyperthyroidism symptoms o Tachycardia, palpitations, angina, hypertension, insomnia, tremors, headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss, appetite changes, sweating, heat intolerance, others Patient Teaching Teach patient to take thyroid drugs once daily in the morning o (on empty stomach in the morning at least 30 minutes before breakfast) don’t want to take it later in the day because will stay up will have blood work taken initially Teach patient to take the medications at the same time every day and not to switch brands without physician approval report any unusual symptoms, chest pain, or heart palpitations not to take over-the-counter medications without physician approval therapeutic effects may take several months to occur importance of alerting health care providers of thyroid medication use (wear medical alert bracelet) o May enhance activity of anticoagulants- Warfarin (Coumadin)- monitor INR levels o Diabetic patients may need increased dosages of hypoglycemic meds o May decrease serum digoxin levels Monitor serum digoxin level- 0.8 to 2.0 nanograms per milliliter Parathyroid PTH: parathyroid hormone Regulates Ca 2+ and Po 4 o Increase kidney Ca 2+ reabsorption o Increase intestinal absorption of Ca 2+ o Increase bone matrix release of Ca 2+ and Po 4 Main effect is to maintain plasma Ca 2+ levels Primary Hyperparathyroidism 10
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Lecture Notes 85% adenomas; F: 3:1 increase Ca 2+ bone resorption (taking Ca+2 from bone) o Osteopenia (weak, brittle bones) Bones, stones, abdominal groans, and psychic moans Hypertension, bradycardia, shortened QT interval Diagnosis albumin levels and ionized calcium (truly reflective of free calcium levels- better value than just total calcium) Ultrasound; MRI Hypercalcimia Treatment Loop diuretics (Lasix) w/ hydration NSS (give fluid and urinate out excess Ca+2) Calcitonin (promote calcium to be REABSORBED by bone) and IV bisphosphonate Surgical removal o risks for injury to the recurrent laryngeal nerves o hypoparathyroidism due to resection or devascularization of all parathyroid glands.
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  • Spring '16
  • Kim McCarron

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