Discharge And Home Healthcare Guidelines

Instruct the patient on all medications regarding dosage, route, action, and adverse effects. Instruct the patient to avoid antacids that contain aluminum and about the higher risk for recurrence if he or she is taking diuretics. Instruct the patient to eat foods high in phosphorus, such as meats (kidney, liver, and turkey), milk, whole-grain cereals, dried fruits, seeds, and nuts. Many carbonated drinks are high in phosphate as well. Discuss with the patient how to prevent reoccurrence of hypophosphatemia.

DRG Category: 300 Mean LOS: 6.3 days Description: MEDICAL: Endocrine Disorders with CC

I I ypothyroidism occurs when the thyroid gland produces a deficient amount of the thyroid hormones, thus resulting in a lowered basal metabolism. Many individuals with mild hypothyroidism are frequently undiagnosed, but the hormone disturbance may contribute to an acceleration of atherosclerosis or complications of medical treatment, such as intraoperative hypotension and cardiac complications after surgery. In severe hypothyroidism, a hydrophilic ("water-loving") mucopolysaccharide is deposited throughout the body, causing nonpitting edema (myxedema) and thickening of the facial features. The most severe level of the disease is myxedema coma, a life-threatening state that is characterized by cardiovascular collapse, severe electrolyte imbalances, respiratory depression, and cerebral hypoxia.

Hypothyroidism is generally classified as cretinism, juvenile hypothyroidism, and adult hypothyroidism. Cretinism is a state of severe hypothyroidism found in infants. When infants do not produce normal amounts of thyroid hormones, their skeletal maturation and central nervous system development are altered, resulting in retardation of physical growth or mental growth, or both. Juvenile hypothyroidism is most often caused by chronic autoimmune thyroiditis and affects the growth and sexual maturation of the child. Signs and symptoms are similar to adult hypothyroidism, and the treatment reverses most of the clinical manifestations of the disease.

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