Hypothyroidism: NCLEX Priorities
Hashimoto's, levothyroxine timing, TSH monitoring, myxedema coma.
Hypothyroidism is deficient thyroid hormone. NCLEX tests Hashimoto's, levothyroxine teaching, and myxedema coma.
Recognition
Weight gain, cold intolerance, fatigue, constipation, bradycardia, dry skin, hair loss, menorrhagia, depression. Hashimoto's (autoimmune) most common cause in US.
Treatment
Levothyroxine lifelong. Take on empty stomach (60 min before food, 4h before calcium/iron/PPI). TSH-guided dosing, check 6-8 weeks after change.
Myxedema coma
Severe hypothyroidism. Hypothermia, bradycardia, hypotension, altered mental status. IV levothyroxine, hydrocortisone (rule out adrenal insufficiency), supportive care, warm slowly.
Frequently asked
Pregnancy and levothyroxine?
Dose typically needs to increase 25-50% in pregnancy. Closely monitor TSH.
Subclinical hypothyroidism, treat?
TSH 4.5-10 with normal T4. Treat if symptoms, antibodies, pregnancy planning.
Quick check
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