Immunosuppressive/Autoimmune Disorders.

Autoimmune disorders are a category of diseases in which the immune system attacks healthy cells as a result of a dysfunction of the acquired immune system. Clinical presentation and diagnosis are disease specific and often correspond with the degree of inflammation, as well as the systems involved. Treatment varies based on the specific disease, its stage of presentation, and patient symptoms. The primary goal of treatment is to decrease inflammation, minimize symptoms, and lessen the potential for relapse. Graves disease, Hashimoto thyroiditis, rheumatoid arthritis, Crohn disease, ulcerative colitis, systemic lupus erythematosus, and multiple sclerosis are discussed in this article.

Thyroid storm during pregnancy. A medical emergency.

Thyroid storm is the major risk to pregnant women with thyrotoxicosis. This life-threatening condition is more likely to occur with another precipitating factor such as labor and delivery, surgical delivery, infection, or trauma. Thyroid storm most often occurs in patients with undertreated or undiagnosed hyperthyroidism. As many as 20% to 30% of cases can end in maternal and fetal mortality. Therefore, critical care nurses must be able to recognize and initiate proper medical and nursing interventions promptly.

Hyperthyroidism in elderly patients.

Hyperthyroid disorders occur in older people and often are present with atypical findings or as apathetic hyperthyroidism. Hyperthyroidism exacerbates underlying chronic disease, especially cardiovascular conditions. Elderly people can be treated successfully and stabilized with careful screening, astute diagnostics, and appropriate therapy.

Hyperthyroidism: diagnosis and management of Graves' disease.

Hyperthyroidism, or thyrotoxicosis, results when the body's tissues are exposed to excessive levels of thyroid hormone. Hyperthyroidism affects 2% of women but only one-tenth as many men. Graves' disease is the most common form of hyperthyroidism, often occurring in young adults. It is an autoimmune disorder with an important genetic component. Hyperthyroidism's hallmarks include goiter and myriad signs and symptoms related to increased metabolic activity in virtually all body tissues. Increased sensitivity to circulating catecholamines adds to the clinical picture. Diagnosed by patient history, physical examination, and laboratory tests, Graves' disease is treated with antithyroid drugs, radioactive iodine, and/or surgery, plus supportive therapy. A good treatment outcome can be expected; long-term follow-up is indicated.

Graves' ophthalmopathy.

Graves' disease is an inflammatory condition affecting the thyroid gland and the eye. The triad of exophthalmos, goiter, and hyperthyroidism is classic Graves' disease. Each of the signs may appear in an individual patient, although separated by weeks, months, or years. The primary cause of Graves' disease is unknown and cannot be treated satisfactorily; however, the complications may be treated.

Antepartal nursing management of Grave's disease.

The signs and symptoms of Grave's disease may be difficult to distinguish from the normal thyroid changes that occur in pregnancy. A brief review of thyroid physiology, thyroid changes during pregnancy, the effect of Grave's disease during pregnancy on the woman and fetus, and an assessment tool for use during the antepartal period is presented. Recommendations of specific areas of need seen in the pregnant Grave's patient during the antepartal period are also outlined.