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Teaching and Learning Presentation
Dave Jay S. ManriquezVancouver Community College
Agenda
At the end of the post conference, the listeners will be able to learn the following topics to be discuss.
1. Hypothyroidism2. Constipation in elderly3. Lax A Day (PEG)4. Hemorrhoids5. Anodan HC6. PRN Medication
Hypothyroidism
Develops when the thyroid gland fails to produce or secrete as much thyroxine (T4) as the body needs. Because T4 regulates such essential functions as heart rate, digestion, physical growth, and mental development, an insufficient supply of this hormone can slow life sustaining processes, damage organs and tissues in every part of the body, and lead to life-threatening complications.
The thyroid gland regulates the metabolic functions of the body in virtually every cell. Everything from the brain to the skin is affected by the hormone made by the thyroid gland.
Hypothyroidism, "It slows you down, It makes you lethargic and fatigued. Your hair becomes brittle, and your skin becomes dry. You become cold much easier than the average person.”
Types of Hypothyroidism Primary hypothyroidism occurs due to improper functioning of the thyroid gland Secondary hypothyroidism occurs due to inadequate stimulation of thyroid gland by thyroid
stimulating hormone (TSH) Signs and Symptoms
Tiredness/ weakness Weight gain with poor appetite Dry skin Cold sensation Hair loss(diffuse alopecia) Nail growth is retarded Poor concentration/memory loss Constipation Dyspnea Hoarseness of voice Hearing Impairment Carpal tunnel syndrome
Treatment
Goal: To mimic normal, physiological levels and alleviate signs, symptoms, and biochemical abnormalities.
Treatment should be tailored to individual needs. Treatment of choice:
Levothyroxine (LT4) replacement therapy
LAX A DAY
Polyethylene glycol 3350 (PEG 3350) belongs to the class of medications called laxatives. PEG 3350 is used for the relief of occasional constipation. It works by softening the stools and keeping water in the intestines. This causes colon muscles to contract and produce a bowel movement more quickly.
The recommended dose is 17 g (1 sachet or heaping tablespoon) of PEG 3350 once a day. The powder should be added to 250 mL (1 cup) of water, juice, pop, coffee, or tea and stirred until all the contents are dissolved. Drink the solution as soon as it's made.
It may take 2 to 4 days for the medication to work. Do not use this product for longer than 7 days unless recommended by your doctor. Prolonged or excessive use may result in electrolyte imbalance and laxative dependence.
PEG 3350 should not be taken by anyone who: is allergic to PEG 3350 or to any of the ingredients of the medication has an intestinal blockage
Side Effects
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects. abdominal cramps or bloating diarrhea excessive stool frequency flatulence (gas) nausea
Hemorrhoids Hemorrhoids are vascular cushions in the anal canal and are a normal part of
human anatomy. These cushions or plexus normally help to seal the upper anal canal and
contribute to continence. Become medical problems only if they become enlarged, inflamed,
thrombosed, or prolapsed.Dilated or enlarged veins in the lower portion of the rectum or anus.
Types of Hemorrhoids Those originating above the dentate line which are termed
internal Those originating below the dentate line which are termed
external
Causes Most popular etiologic theory states that
Hemorrhoids result from chronic straining at defecation.
Continued straining causes engorgement and bleeding, as well as hemorrhoidal prolapse.
Other causes that can aggravate the condition: Constipation Diarrhea Sitting or standing for long periods of time Obesity Heavy Lifting Pregnancy
Symptoms All Classes:
Bleeding from the rectum that appears as bright red blood. The bleeding may vary from light spotting on the toilet paper to copious amounts in the toilet bowl
Constipation or diarrhea Straining with defecation
External hemorrhoids Rarely painful unless thrombosed Rarely bleeding (except for clot eroding through skin) A palpable “lump” can be felt often when the hemorrhoid has thrombosed
Internal hemorrhoids Usually painless More severe internal hemorrhoids may result in feeling of fullness and incomplete
evacuation after defecation Protruding hemorrhoids present as a mass with more prominent bleeding If 4th degree internal hemorrhoid, increased risk of strangulation and/or thrombosis with
acute pain Individuals often have fecal soiling --> pruritus and irritation
Treatment and Prevention Treatments are classified into three categories: 1) Dietary and lifestyle modification. 2) Non operative / office procedures. 3) Operative hemorrhoidectomy. Eat high fiber diet Drink Plenty of Liquids Fiber Supplements Exercise Avoid long periods of standing or sitting Don’t Strain Go as soon as you feel the urge
Anodan HC It is used to treat hemorrhoids. It may also be used to treat discomfort after surgery to
the anal area and other conditions affecting the anal area. It works by reducing swelling, irritation, and itching.
Suppositories: Wash and dry the affected anal area. Insert one suppository into the anus in the morning and evening and after each bowel movement. Continue treatment until the acute phase of pain and discomfort passes and inflammation subsides.
Check with your doctor as soon as possible if any of the following side effects occur: burning and itching of skin chills diarrhea false sense of well-being fever infection painful, red, or itchy pus-containing blisters in hair follicles rectal bleeding, burning, dryness, itching, or pain not present before treatment sensation of pins and needles
Acetaminophen and Vitamin B12 Analgesics such as acetaminophen or ibuprofen
can be used for pain relief. Avoid ibuprofen if bleeding is present.
Vitamin B complex plays a role in facilitating digestion. B complex may relieve hemorrhoids by improving digestion. This can alleviate constipation that can lead to hemorrhoids. Vitamin B12, additionally, is a bioflavonoid and may decrease inflammation and irritation.
PRN Medication Administering a PRN1. Scan a PRN that you would like to administer. The medication will highlight green.2. Type in the reason for administering.3. Click sign off. Responding to a PRN1. Go to the resident’s Homepage, PRN tab.2. Click on PRN response required link under the reminder section.3. Choose your response and type in comment if necessary, click Save. To request a refill1. Click the Pharmacy Request tab. Refill page will appear by default.2. Select the appropriate Order Type option (PRN or RoutineMeds)3. Select the checkbox of the refill request.4. Click Send Order.
Question and Answer:1. What type of laxative is LAX – A – DAY?a. Stimulantsb. Bulk Formingc. Osmoticd. Stool SoftenersAnswer: C. Osmotic2. What medication can cause constipation? Select all that apply.e. Diureticsf. Cholinergicsg. Painkillersh. AdrenergicsAnswer: A. Diuretics and C. Painkillers
3. What vitamin help in digestion?a. Vitamin Ab. Vitamin Bc. Vitamin Cd. Vitamin D
Answer: b. Vitamin B
4. What sign and symptoms of hypothyroidism that are prominent in an elderly? Select all that apply.a. Cold Sensationb. Constipationc. Weight Lossd. Tiredness
Answer: a. Cold Sensation, b. Constipation, and c. Tiredness
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