Nursing Diagnosis for Hypothyroidism

Hypothyroidism is a condition in which the gland tirod less active and produces too little thyroid hormone. Hypothyroidism is a very heavy-called myxoedema.

If inadequate thyroid hormone production will compensate the thyroid gland to increase secretion in response to stimulation hormone TSH.
The decrease in the secretion of hormones, thyroid hormones will lower basal metabolic rate which will be used effects all body systems. Metabolic processes are influenced by:

• Decreased production of stomach acid.
• Decreased intestinal motility.
• Decreased heart rate.
• Impaired neurological function.
• The decrease in heat production.

Decreased thyroid hormone will also interfere with the metabolism of fat which would be an increase in cholesterol and triglyceride levels so that potential clients experiencing atherosclerosis. Accumulation of hydrophilic proteoglycans in interstitial voids as the pleural cavity, cardiac and abdominal as a sign of myxoedema. Formation of erythrocytes that are not optimal sebgai impact of declining thyroid hormone allows the client to have anemia.

Symptoms of Hypothyroidism

• Decreased appetite.
• Constipation.
• Growth of bones and teeth are slow.
• Hoarseness.
• Speaking slowly.
• Eyelid down.
• Facial swelling.
• Thin hair, dry and rough.
• Skin dry, rough, scaly and thickened.
• Slow pulse.
• Slow body movements.
• Weak.
• Dizziness.
• Tired.
• Pale.
• Pain in the joints or muscles.
• Not resistant to cold.
• Depression.
• Decreased sense of taste and smell function.
• Eyebrow loss.
• Sweat is reduced.

Early symptoms of hypothyroidism are nonspecific, but extreme fatigue sufferers difficult to implement the day-to-day work in full, or participate in a common activity undertaken. Reports of hair loss, brittle nails and dry skin that is often found, and complaints of numbness and paresthesias in the fingers may occur. Sometimes the sound becomes rough, and the patient may complain of hoarseness. Menstrual disorders such as menorrhagia or amenorrhea will occur in addition to loss of libido. Hypothyroidism affects women five times more frequently than men and is most common in the age of 30-60 years.

Severe hypothyroidism resulting in body temperature and pulse rate subnormal. Patients typically begin to experience weight gain occurred even without an increase in food intake, although patients with severe hypothyroidism can be seen cachexia. The skin becomes thick due to accumulation of mucopolysaccharides in the subcutaneous tissue. Hair thinning and loss, and expressionless face looks like a mask. Patients often complain of feeling cold even in warm environments.

At first, the patient may be irritable and complained of feeling weak, but with the continuation of these conditions, the emotional response to the above will be reduced. Mental processes become dull and seem apathetic patients. Talk becomes slow, enlarged tongue, and the size of the hands and feet increases. Patients often complain of constipation and deafness can occur.

In hypothyroidism continued, will lead to dementia and cognitive changes accompanied a distinctive personality. Inadequate respiration and apnea during sleep may occur in severe hypothyroidism. Pleural effusion, pericardial effusion and respiratory muscle weakness may occur.

Severe hypothyroidism will be accompanied with a significant increase in serum cholesterol levels, atherosclerosis, coronary heart disease and poor left ventricular function. Further hipotiroidime patients will experience hypothermia and abnormal sensitivity to preparaf sedatives, opioids and anesthetics, and therefore all of these drugs is only given on certain conditions.

Patients with hypothyroidism who have not been identified and is undergoing surgery, will face a higher risk for experiencing intraoperative hypotension, postoperative congestive heart failure and mental status changes.


Other clinical features:

• Inaction, slowing the intellect, and the awkward slow motion.
• The decrease in heart rate, cardiac enlargement (myxoedema heart) and decreased cardiac output.
• Swelling and edema of the skin, especially under the eyes and around the ankle.
• The decrease in metabolic rate, decrease caloric needs, decreased appetite and nutrient absorption from the gastrointestinal tract.
• Constipation.
• Changes in reproductive function.
• Dry, scaly skin and hair of the head and body are thin and fragile.

Nursing Diagnosis for Hypothyroidism

1. Ineffective breathing pattern related to depression of ventilation.
2. Constipation related to a decrease in gastrointestinal.
3. Altered Body Temperature.
4. Activity intolerance related to fatigue and decreased cognitive processes.
5. Altered thought processes related to metabolic disorders and cardiovascular and respiratory status changes.
6. Deficient knowledge about treatment programs for lifelong thyroid replacement therapy.