Physiological Adaptation Q 171
A newborn has been diagnosed with hypothyroidism. In discussing the condition and treatment with the family, the nurse should emphasize:
A. They can expect the child will be mentally retarded.
B. Administration of thyroid hormone will prevent problems.
C. This rare problem is always hereditary.
D. Physical growth/development will be delayed.
Correct Answer: B. Administration of thyroid hormone will prevent problems.
Early identification and continued treatment with hormone replacement correct this condition.
Option A: Mental retardation can be prevented with early detection and treatment. Neurologic sequelae, characterized by spasticity, tremor, and hyperactive deep tendon reflexes, are found frequently in severe cretinism, but not in mild cretinism or acquired hypothyroidism. The severity of neurologic sequelae parallels mental retardation. Early therapy apparently prevents, in part, these sequelae.
Option C: Congenital hypothyroidism is caused by iodine deficiency and is occasionally exacerbated by naturally occurring goitrogens. In the majority of patients, CH is caused by abnormal development of the thyroid gland (thyroid dysgenesis) which is a sporadic disorder and accounts for 85% of cases, and the remaining 15% of cases are caused by dyshormonogenesis. The clinical features of congenital hypothyroidism are so subtle that many newborn infants remain undiagnosed at birth and delayed diagnosis leads to the most severe outcome of CH, mental retardation, emphasizing the importance of neonatal screening.
Option D: The growth and development of an infant with congenital hypothyroidism can be normal if it is detected and treated early. In overt hypothyroidism, the severe impairment of linear growth leads to dwarfism, which is characterized by limbs that are disproportionately short compared with the