18 April 2010

What is Simple Goiter Symptoms and Nursing Dignosis Intervention

Sunday, April 18, 2010
A lack of iodine in the patient’s diet (endemic, simple goiter) causes the thyroid gland to become enlarged. This is seen less today because iodine is added to table salt. The thyroid gland can also become enlarged by ingesting large amounts of goitrogenic drugs or goitrogenic foods that decrease production of thyroxine,
such as strawberries, cabbage, peanuts, peas, peaches, and spinach. This results in sporadic simple goiter. A simple goiter is not caused by inflammation or neoplasm.
PROGNOSIS:Prognosis is good if treated and patients go on to live normal lives.
• Difficulty in swallowing (dysphagia) due to a large thyroid pressing on the esophagus
• Enlarged thyroid gland
• Respiratory distress from the large gland, causing pressure on the trachea
• A tight feeling in the throat from a large gland
• Coughing
• Decreased or normal serum T4 level caused by an underactive thyroid.
• Increased serum TSH, by the pituitary gland, attempting to stimulate or shut off production of the thyroid in making thyroid hormone.
• RAIU uptake normal or increased—a radioactive isotope is injected into a vein. A scan of the thyroid is done to visualize the thyroid more completely.
• Ultrasound enables sound waves to bounce off the gland, giving the size and location of any nodules.
• If increased TSH, administer hormone replacement with levothyroxine (T4),dessicated thyroid, or liothyronine (T3).
• If the thyroid gland is overactive, then administer small doses of Lugol’s solution or potassium iodide solution.
• If the simple goiter cannot be reduced through medication, then a thyroidectomy is performed during which all or part of the thyroid is removed.
• Imbalanced nutrition: less than what body requires; related to inadequate intake in relation to metabolic needs
• Fatigue related to sleep deprivation
• Hyperthermia related to increased metabolic rate

• Avoid goitrogenic foods or drugs in sporadic goiter since they make thyroid hormone production.
• Use iodized salt to prevent and treat endemic goiter, since the thyroid needs iodine to make thyroid hormone.
• Explain to patient:
• The need for life-long thyroid replacement after thyroidectomy and radioactive iodine.
• The need for intermittent lab work to monitor the thyroid.
• Visits to the primary care practitioner to monitor size of thyroid gland.
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