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Kami berharap bahwa Anda menikmati presentasi ini. Untuk men-download , silahkan rekomendasi presentasi ini kepada teman-teman Anda dalam jaringan sosial. Tombol yang haris diklik terletak di bawah posting ini. Terima kasih. Diterbitkan oleh Ridwan Hermawan Telah diubah "4 tahun yang lalu. Kadar TSHs yang rendah menunjukkan hipertiroid. Does not respond to thyrotropin-releasing hormone TRH. Hypokalemia occurs because of GI losses and diuresis.
Tanda : atrofi otot, tampak kelelahan Sirkulasi Gejala: palpitasi, nyeri dada angina. Takikardia saat istirahat. Sirkulasi kolaps, syok krisis tirotoksikosis. Provide psychological support. Prevent complications. Discharge Goals Homeostasis achieved. Patient effectively dealing with current situation. Plan in place to meet needs after discharge. Note widened pulse pressure. Widened pulse pressure reflects compensatory increase in stroke volume and decreased systemic vascular resistance SVR.
Monitor central venous pressure CVP , if available. Provides more direct measure of circulating volume and cardiac function. Provides a more accurate assessment of tachycardia. Auscultate heart sounds, noting extra heart sounds, development of gallops and systolic murmurs.
Document dysrhythmias. Auscultate breath sounds, noting adventitious sounds e. Early sign of pulmonary congestion, reflecting developing cardiac failure. Rapid dehydration can occur, which reduces circulating volume and compromises cardiac output. Note urine specific gravity. Significant fluid losses through vomiting, diarrhea, diuresis, diaphoresis can lead to profound dehydration, concentrated urine, and weight loss.
Weigh daily. Observe for adverse side effects of adrenergic antagonists, e. Administer IV fluids as indicated. Elevation may alter cardiac contractility. Pulmonary infection is most frequent precipitating factor of crisis.
May demonstrate effects of electrolyte imbalance or ischemic changes reflecting inadequate myocardial oxygen supply in presence of increased metabolic demands. Cardiac enlargement may occur in response to increased circulatory demands. Pulmonary congestion may be noted with cardiac decompensation. Provide hypothermia blanket as indicated. Display improved ability to participate in desired activities.
Note development of tachypnea, dyspnea, pallor, and cyanosis. Provide for quiet environment; cool room, decreased sensory stimuli, soothing colors, quiet music.
Reduces stimuli that may aggravate agitation, hyperactivity, and insomnia. Encourage patient to restrict activity and rest in bed as much as possible.
Helps counteract effects of increased metabolism. Provide comfort measures, e. May decrease nervous energy, promoting relaxation. Provide for diversional activities that are calming, e. Allows for use of nervous energy in a constructive manner and may reduce anxiety. Avoid topics that irritate or upset patient. Discuss ways to respond to these feelings. Increased irritability of the CNS may cause patient to be easily excited, agitated, and prone to emotional outbursts. Discuss with SO reasons for fatigue and emotional lability.
Understanding that the behavior is physically based may enhance coping with current situation and encourage SO to respond positively and provide support for patient. Administer medications as indicated:Sedatives, e.
Combats nervousness, hyperactivity, and insomnia. May be hypervigilant, restless, extremely sensitive, or crying or may develop frank psychosis. Assess level of anxiety. Anxiety may alter thought processes. Provide quiet environment; decreased stimuli, cool room, dim lights. Present reality concisely and briefly without challenging illogical thinking. Limits defensive reaction. Promotes continual orientation cues to assist patient in maintaining sense of normalcy.
Provide support as needed. Aids in maintaining socialization and orientation. Provide safety measures, e. Administer medication as indicated, e.
Weigh daily and report losses. Continued weight loss in face of adequate caloric intake may indicate failure of antithyroid therapy. Encourage patient to eat and increase number of meals and snacks, using high-calorie foods that are easily digested. Aids in keeping caloric intake high enough to keep up with rapid expenditure of calories caused by hypermetabolic state. Avoid foods that increase peristalsis e.
Increased motility of GI tract may result in diarrhea and impair absorption of needed nutrients. Consult with dietitian to provide diet high in calories, protein, carbohydrates, and vitamins. May need assistance to ensure adequate intake of nutrients, identify appropriate supplements. Administer medications as indicated:Glucose, vitamin B complex;Insulin small doses.
Given to meet energy requirements and prevent or correct hypoglycemia. Aids in controlling serum glucose if elevated. Report anxiety reduced to a manageable level. Identify healthy ways to deal with feelings.
Mild anxiety may be displayed by irritability and insomnia. Monitor physical responses, noting palpitations, repetitive movements, hyperventilation, insomnia. Stay with patient, maintaining calm manner.
Speak in brief statements, using simple words. Attention span may be shortened, concentration reduced, limiting ability to assimilate information. Reinforce expectation that emotional control should return as drug therapy progresses. Provides information and reassures patient that the situation is temporary and will improve with treatment. Administer antianxiety agents or sedatives and monitor effects. Refer to support systems as needed, e. May be used in conjuction with medical regimen to reduce effects of hyperthyroid secretion.
Identify measures to provide protection for eyes and prevent complications. Elevate the head of the bed and restrict salt intake if indicated. Decreases tissue edema when appropriate, e.
Instruct patient in extraocular muscle exercises if appropriate. Improves circulation and maintains mobility of the eyelids. Provide opportunity for patient to discuss feelings about altered appearance and measures to enhance self-image. Protruding eyes may be viewed as unattractive. Appearance can be enhanced with proper use of makeup, overall grooming, and use of shaded glasses. Lubricates the eyes, reducing risk of lesion formation. Given to decrease rapidly progressive and marked inflammation.
Can decrease edema in mild involvement.
Indonesian Clinical Practice Guidelines for Hyperthyroidism
Tiroiditis adalah peradangan pembengkakan tiroid. Tiroid adalah kelenjar kecil di leher yang berperan penting dalam mengendalikan metabolisme. Peradangan dapat mengakibatkan meningkatnya tiroid hipertiroidisme atau berkurangnya aktivitas tiroid hipotiroidisme. Jenis paling umum adalah peradangan tiroid Hashimoto. Bentuk lain peradangan pembengkakan tiroids seperti tiroiditis subakut dan tiroiditis diam dapat menyebabkan hipertiroidisme.
GD: A long-term quality-of-life follow up of patients randomized to treatment with ATDs, radioiodine, or surgery. Adesina O. Endocrine Abstracts. Age and gender predict outcome of treatment for Graves hyperthyroidism. J Clin Endocrinol Metab. Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologist. Endocr Pract.