Chapter 63 Flashcards
Butterfly shaped gland
Over production of thyroid hormones
Thyroid
Thyrotoxicosis
Most common hyperthyroidism thyroid disorder which is auto immune
Graves’ disease- body destroys thryroid gland - which eventually turns into hypothyroidism
is hallmark of hyperthyroidism
Other s/s
**Heat intolerance Budging eyes Hungry High pulse /Bp Ble edema Hand tremors Dyspnea Hair loss Mood swings Wt loss Goiter Increase sexual drive
Exophthalmos - does not go away even if thyroid is fixed
Bulging eyes
Dx of thyroid issue
TSH
If too little- hypothyroid
Too much- hyperthyroid
Iodine - thyroid scan , ECG, ultrasound
Excessive level of thyroid hormones - temperature increase can indicate this
Nursing interventions
what may cause/trigger -
Thyroid storm
Severe HTN , sweating
Decrease stimulation, limit visitors , quiet
trauma , infection, pregnancy, Palpation of goiter
Radioactive iodine tx does what
Radiation precautions pg. 1269 chart 63-4
Save urine - radiation bag ?
Pill to Hypothyroidism tx to destroy portion of gland
Thyroidectomy complication ?
Thyroid storm
May reduce my minimizing before surgery
Thyroidectomy post op monitoring
Avoid extending neck , watch suture line
Airway is priority - hoarseness is normal
Hypocalcemia and tetany
Thyroid storm
Hypothyroidism s/s
Pg1271
Chart- 63-6
Myxedema - non pitting edema around eyes, hands , feet, shoulder blades, tongue , larynx- voice deepens
Myxedema coma- non pitting edema, heart flabby and chamber enlarges ; results in decreased CO which compounds low metabolism tissue and organ failure - mortality rate high
Goiter and low thyroid hormone levels
Low energy, weight gain, cold intolerance, low Sex drive , low temp, paresthesia, menses changes
Thick tounge, blank expression, slow speech/response
Slow HR, low respirations
Depression, apathetic , sluggish, withdrawn
Chart 63-7
Page 1274
Myxedema coma priority
Airway
IV fluids
Lifelong thyroid replacements
Vital signs frequently
Increase in PTH from parathyroid gland in response to calcium levels
Kidney stones
Decrease bone production and increase bone destruction (osteoporosis and arthritis)
Hyperparathyroidism
Hyperparathyroidism tx
Monitor?
Diuretics Hydration Cinacalcet Calcitonin with glucocorticoids Phosphates
Cardiac rhythm
Paresthesia
Prevent injury
Surgery to remove gland- calcium and vit D lifelong
Decreased function of parathyroid gland resulting in hypocalcemia
Caused by low magnesium, autoimmune/idiopathic/latrigenic/surgical removal of all parathyroid tissue
S/s tingling, numbness, seizures, muscle contractions
Tx
Hypo parathyroidism
Calcitrol, magnesium vit d
Hypothyroidism lab tests would see :
Decreased T3 and T4
And elevated TSH - thyroid gland is not responding
