Question

1. A patient with hypothyroidism is receiving Synthroid for hormone replacement. The nurse knows that thyroid hormones interact with certain medications.

1a. What are the education needs of patients requiring corticosteroids therapy?

2. A patient has just undergone thyroidectomy for treatment of thyroid cancer.

2a. For what postoperative complications should the nurse assess the patent?

3. You are caring for a patient with Addison disease, which results in adrenocortical insufficiency.

3a. What are the 3 types of hormone secreted by the adrenal cortex?

  

3b. Which hormones are involved in Addison disease?

Answer 1

1 a) Corticosteroids are used to provide relief for inflamed areas of body. They lessen swelling, itching, allergies. They are used as a part of treatment in number of diseases. They slow or stop immune system reaction that triggers inflammation. In general these are safe medicine when taken according to prescription by doctor. There are so many possible side effects too.

When corticosteroids are introduced, information concerning side effects and recommendations for lifestyle changes for preventing side effects is provided to patients. In some patients strict dietary recommendations are made, some are advised to follow strict changes in lifestyle. All these make patients develop fear about using drug. If proper information and advice is given it will be used properly and its misuse can be prevented. Proper nursing instruction should be given to patients about diet, lifestyle, dose and time of intake of medicine, possible side effects, emergency management of side effects, interactions with other drug.Patient can be educated by giving them details written in paper format .Only by proper education of patient its misuse can be prevented and adverse effects can be reduced.

2 a)

Thyroidectomy is the surgical removal of all or part of thyroid gland.

• Bleeding
• Wound infection
• Hypoparathyroidism is the most common complication after thyroidectomy due to unintentional removal of parathyroid glands or poor blood flow to glands.Patients thus require life long treatment with calcium and vitamin D ,so this complication is considered serious.
• Respiratory obstruction : due to hemorrhage, hematoma,etc.
• Recurrent Laryngeal Nerve Palsy : results in hoarseness of sound or aphonia.
• Thyrotoxic crisis

3 a) Adrenal cortex produces 3 types of steroid hormones:

• Mineralocorticoids- influence salt water balance.Primary hormone is aldosterone
• Glucocorticoids - mechanism in immune system ,metabolism.Min hormone is cortisol hormone.
• Androgens - reproductive hormones like testosterone

b)Addison disease affected by insufficient production of hormone cortisol and in some cases hormone aldosterone.