Activity intolerance related to weakness and apathy
OUTCOMES. Energy conservation; Endurance; Self-care: Activities of daily living; Ambulation: Walking; Circulation status; Immobility consequences: Physiological; Mobility level; Nutritional status: Energy; Symptom severity
INTERVENTIONS. Energy management; Exercise promotion; Exercise therapy: Ambulation; Nutritional management; Medication management; Surveillance; Vital signs monitoring
^ PLANNING AND IMPLEMENTATION Collaborative
Most patients are diagnosed and treated on an outpatient basis. The goal of treatment is to return the patient to the euthyroid (normal) state and to prevent complications. The treatment of choice is to provide thyroid hormone supplements to correct hormonal deficiencies. Treatment of the elderly patient is approached more cautiously because of higher risk for cardiac complications and toxic effects. The medication should not be given if the pulse rate is greater than 100. The treatment is considered to be life-long, requiring ongoing medical assessment of thyroid function. Polypharmacy is a significant concern for the hypothyroid patient. Several classifications of drugs are affected by the addition of thyroid supplements, including beta blockers, oral anticoagulants, bronchodilators, digitalis preparations, tricyclic antidepressants, and cholesterol-lowering agents.
Because significant cardiovascular disease often accompanies hypothyroidism, the patient is at risk for cardiac complications if the metabolic rate is increased too quickly. Therefore, the patient needs to be monitored for cardiovascular compromise (palpitations, chest pain, shortness of breath, rapid heart rate) during early thyroid therapy. The diet for the hypothyroid patient is generally low in calories, high in fiber, and high in protein. As the metabolic rate rises, the caloric content can be increased. The patient's intolerance to cold may extend to cold foods, making meal planning more difficult.
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