Medical Surgical Thyroid #4

Question

The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto’s thyroiditis. After analyzing assessment data, the nurse will select which of the following nursing diagnoses?

Answers

  1. Activity intolerance related to weakness, fatigue, and slowed metabolism.
    • Rationale:

      This answer is correct because fatigue and weakness related to the slowed metabolism causes activity intolerance. This makes activities of daily living difficult due to the extreme fatigue the client feels. Other symptoms include constipation, fatigue, weakness, hair loss, skin dryness, depression, bradycardia, weight gain, sensitivity to cold, and swelling in the extremities. Unfortunately, with Hashimoto’s thyroiditis, treatment with synthetic hormones is generally ineffective against these symptoms.

  2. Fluid volume deficit related to dehydration and poor skin turgor.
    • Rationale:

      This answer is not correct because fluid volume deficit, dehydration, and poor skin turgor are not associated with Hashimoto’s thyroiditis. Symptoms do include constipation, fatigue, weakness, hair loss, skin dryness, depression, bradycardia, weight gain, sensitivity to cold, and swelling in the extremities. Unfortunately, with Hashimoto’s thyroiditis, treatment with synthetic hormones is generally ineffective against these symptoms.

  3. Risk for insomnia related to hyperactive state.
    • Rationale:

      This answer is not correct because the client with Hashimoto’s thyroiditis does not have a risk for insomnia related to the hyperactive state because this condition causes extreme fatigue. This client would tend to have difficulty getting out of bed and not sleeping too much due to the fatigue. Due to the slowed metabolism, the client would be hypoactive, not hyperactive.

  4. Risk for bleeding related to compromised immunologic status.
    • Rationale:

      This answer is not correct because the client with Hashimoto’s thyroiditis does not have a risk for bleeding. This autoimmune condition attacks only the thyroid, which does not affect the client’s bleeding tendency.

Overview

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks the thyroid. Hypothyroidism secondary to Hashimoto’s thyroiditis causes fatigue and weakness, related to a slowed metabolism, which may affect activity levels.

Explanation

Learning Outcomes

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks the thyroid. This causes a decrease in thyroid hormone leading to hypothyroidism. Except for the cause, the symptoms of Hashimoto’s thyroiditis is the same as hypothyroidism. The symptoms include constipation, fatigue, weakness, hair loss, skin dryness, depression, bradycardia, weight gain, sensitivity to cold, and swelling in the extremities. Unfortunately, with Hashimoto’s thyroiditis, treatment with synthetic hormones is generally ineffective against these symptoms.

Test Taking Tip

As you are remembering various conditions, just learn hypothyroidism and know that Hashimoto’s thyroiditis is a type of hypothyroidism. Place Hashimoto’s thyroiditis in your hypothyroidism “file” in your brain, then you only have to learn hypothyroidism. The same can be done for Graves’ Disease and hyperthyroidism.

Video Rationale