Chapter 18 (Thyroid Emergencies) Flashcards Preview

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Flashcards in Chapter 18 (Thyroid Emergencies) Deck (24)
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1

Thyroid Gland

- butterfly shaped organ
- anterior to trachea
- 2-2.5 cm wide to 3.5 cm length
- produced thyroid hormones that determine:
1. metabolic rate
2. growth rate
3. other body mechanisms

2

Thyroxine

1. stimulates gastrointestinal activity
2. stimulates heart activity
3. increases body temp
4. increases respiration
5. increases cellular metabolism

3

What is hypothyroidism?

not enough thyroid hormone produced

4

Hypothyroidism in the youth?

- cold intolerance
- weight gain
- dry skin
- constipation
- mental slowing
- physical slowing

5

Hypothyroidism in the elderly

same as the youth. more difficult to determine as these are symptoms are similar to other chronic diseases.

6

what is thyrotoxicosis?

too much thyroid hormone produced.

7

what is graves' disease?

enlarged thyroid gland
-origin unknown
-hereditary
-autoimmune suspected

8

What is nodular goiter?

enlarged thyroid gland with multiple nodules.
inflammed:
2% of women
0.2% men

9

what are the signs and symptoms of hyperthyroidism?

-weight loss
-nervousness
-insomnia
-bulging eyes
-tremors
-sweating
-rapid heart rate
-diarrhea

10

what is hypothyroid?

synthetic thyroid hormone
-need to take for life
-usually levothyroxine
-dosage based upon weight, age, and cardiac status

11

what re the three methods of treatment of hyperthyroidism?

1. surgery (last resort)
2. antithyroid medications
3. ablation therapy

12

Ablation therapy

-radioactive iodine to disable thyroid gland
-patient will be hypothyroid so need synthetic hormone replacement

13

treatment of surgery of hyperthyroidism

removal of thyroid gland
-last resort
-complications: hemorrhage, hypoparathyroidism, vocal chord paralysis

14

(treatment) antithyroid medications

- methimazole or propylthiouracil
-relapses usually occur so usually temporary treatment
- side effects: agranulocytosis and hepatitis

15

what are the thyroid emergencies?

- myxedema coma
-thyroid storm

16

what is myxedema coma?

-occurs when body unable to compensate for thyroid hormone deficiency due to some precipitating event
-usually patent not comatose- misnomers
-more common in males and individuals over 70.
-often occurs in winter months (hypothermia)

17

what are the signs and symptoms of myxedema coma?

-deterioration of mental state- confusion, apathy, depression, psychosis
-hypothermia (<95 F)
-hair loss
-facial conditions

18

signs and symptoms of myxedema coma?

-cool, dry skin with non-pitting edema
-bradycardia
-elevated BP early then lowered BP later
- seizures possible

19

treatment of myxedema coma

-normalize patient's temp and respiration
-contact EMS immediately
-IV levothyroxine needed

20

treatment of myxedema coma

- mortality rate 30-60%
-position patient supinely
-maintain airway and circulation
-administer O2 4-6L/min
-monitor vital signs

21

Thyroid storm

- life threatening
- 10-50% fatal
- exacerbation of hyperthyroid state

22

what are the signs and symptoms of thyroid storm?

- exaggeration of hyperthyroid symptoms
- fever
- diaphoresis
- CNS- restlessness, confusion, anxiety, psychosis

23

signs and symptoms of thyroid storm

-GI symptoms- nausea, vomiting, diarrhea, juandice
- increase systolic BP
- widened pulse pressure
- Arrhythmias

24

treatment of thyroid storm

hyperthyroid treatment of medication, ablation therapy, or surgery will follow once the patient is stabilized