Endocrine Part 1 Flashcards
(44 cards)
What does thyroid produce??
T3, T4, Calcitonin
How does calcitonin work?
Decreases serum calcium by taking it from the blood and putting it back in the bone
Tx osteoporosis
What do you need to make hormones?
Dietary Iodine
What hormone gives us energy?
Thyroid hormone
S/S Hyperthyroidthyroidism (Graves)
Energy? Wt: Temp: Attention: Constipation or diarrhea? BP:
TOO MUCH energy Wt: Loss Temp: Hot/sweaty Attention span decreases (can't focus) Nervousness / irritable GI: fast - Diarrhea BP ^ Thyroid enlarges/hypertrophy
How do we diagnose hyperthyroidism?
T4 count (Increased) Thyroid scan
What must a patient do before obtaining a thyroid scan?
DC any iodine containing medication 1 week prior to the scan
What drug contains high levels of iodine?
Amiodarone - may affect thyroid function
5 ways to treat hyperthyroidism
- Anti-thyroids
- Iodine compounds
- Beta blockers
- Radioactive Iodine
- Surgery
What are 2 examples of anti-thyroid medications?
How do they work?
When is it used?
propylthiouracil, methimazole
Stops the thyroid from making hormones
Used preoperatively to stun the thyroid (decrease bleeding risk)
2 examples of iodine compounds
Are these the same as dietary iodine?
How does it work?
How do we give it?
Potassium iodine, strong iodine solution (Lugol’s)
NO
These decreases the size and vascularity go the gland - all endocrine glands are VERY VASCULAR
Give in milk or juice and use a star because it stains teeth
How to BB work in regards to hyperthyroidism?
Who do we not give these to?
Decrease HR, BP, contractility, CO generally, but especially decrease anxiety in these patients
Asthma, DM (masks glucose changes)
How does radioactive iodine work? What does this lead to? Is this adverse?
Destroys the thyroid cells
Hypothyroidism
This is expected, not adverse
How many doses of radioactive iodine are given?
How are they given?
1
PO (liquid or tablet) after pregnancy is ruled out
Precautions to taking radioactive iodine
Stay away from babies and no kissing for 24 hours
What is a thyroid storm?
Also called thyrotoxicosis and thyrotoxic crisis, it is like hyperthyroidism x 100
Could be a rebound effect after radioactive iodine (But can occur without it)
EMERGENCY - ICU: could lead to MI
Post-op teaching of thyroidectomy (total or partial)
Support the neck to avoid any tension on the suture line
Put personal items close by
How do we position a patient after a thyroidectomy?
Where do we check for bleeding?
Elevate HOB to prevent edema in the neck
Check for bleeding behind the neck
Nutrition after thyroid removal
Increased calories because they are burning do many
What would hoarseness indicate after thyroid removal?
What could this lead to?
Damage of the laryngeal nerve
Vocal cord paralysis or airway obstruction & immediate trach if both cords have paralysis
Do we want thyroidectomy patients to speak much?
No, but we need to listen for hoarseness and teach them to report ANY feelings of pressure
ASSUME THE WORST
Why do we keep a trach at the bedside?
Swelling
Laryngeal nerve damage
Hypocalcemia
What could have been removed when removing the thyroid?
How would we know?
Some of the parathyroid glands (there are 4 total)
Assess for LOW CALCIUM - *not enough sedation (think about laryngospasm especially here)
What is not fixed when removing the thyroid?
What do we do about it?
Eye or vision problems
Hypoallergenic tape if they can’t close their lids
Dark glasses for photosensitivity
Artificial tears
