EXAM 2: Thyroid

Question 1

What is T3?

Answer 1

T3 is the more active form of the thyroid hormone and more potent and rapid acting then T4

Question 2

What is the relationship between calcium and phosphorus?

Answer 2

they have an inverse relationship

Question 3

What nutrient is vital for a healthy functioning thyroid and prevention of a goiter?

Answer 3

iodine

Question 4

What is the 2nd most common endocrine disorder?

Answer 4

Hyperthyroidism

Question 5

What is thyrotoxicosis?

Answer 5

excessive output of thyroid hormone (thyroid storm)

Question 6

What will the lab results say for a patient who has been diagnosed with hyperthyroidism?

Answer 6

• low TSH and a high T3/T4

Question 7

What will the lab results say for a patient who has been diagnosed with hypothyroidism?

Answer 7

• high TSH and a low T3/T4

Question 8

What can result from hyperthyroidism?

Answer 8

• graves disease
• thyrotoxicosis
• exophthalmos
• toxic adenoma

Question 9

What can result from hypothyroidism?

Answer 9

• hashimotos (thyroiditis)

- myxedema

Question 10

What causes hypothyroidism?

Answer 10

• atrophy of the thyroid with aging
• therapy for hyperthyroidism
• medications
• radiation to the head or neck
• iodine deficiency/excess

Question 11

How is hypothyroidism treated?

Answer 11

• with levothyroxine:
  > synthetic T4 thats converted to T3
  > start with low dosage (50mcg) and do
  not switch brands
  > take first thing in the AM on a empty
  stomach
  > wait 30-60 minutes before eating
  breakfast or taking other medications

Question 12

How is hyperthyroidism treated?

Answer 12

• propylthiuracil and methimzaole
• radioactive I131
• Na and K iodine solutions
• beta blockers
• thyroidectomy
• ** medication is short term and may result in hypothyroidism ***

Question 13

How should you prep a patient for a thyroidectomy?

Answer 13

• reduce stress and anxiety
• no caffeine
• explain procedure
• demonstrate post up nursing care

Question 14

What should you do post-op after a patient has had a thyroidectomy?

Answer 14

• monitor the dressing for bleeding/hematoma (check back of neck)
• monitor respirations and pain
• place in a semi-fowlers position
• assess the voice but discourage talking (patient will be hoarse)
• assess for hypocalcemia (PTH may have been removed)

Question 15

What are the s/sx of hyperparathyroidism?

Answer 15

• kidney stones ***
• hypercalcemia
• hypophosphatemia

Question 16

How is hyperparathyroidism treated?

Answer 16

• parathyroidectomy (Tscore <2.5)
• stay very hydrated
• mobility = reduction in calcium excretion
• avoid excess calcium

Question 17

What causes hypoparathyroidism?

Answer 17

• thyroidectomy
• parathyroidectomy
• radical neck dissection

Question 18

What are the s/sx of hypoparathyroidism?

Answer 18

• hypocalcemia

- hyperphosphatemia

Question 19

How is hypoparathyroidism treated?

Answer 19

• calcium gluconate
• pentobarbital (decreases neuro irritation)
• parathormone (monitor allergic rxn)
• calm environment
• diet high in Ca & vit. D but low in PO

Question 20

What lab values indicate a problem with the thyroid?

Answer 20

• high TSH and a low T3/T4

- low TSH and a high T3/T4

Question 21

What lab values indicate a problem with the pituitary gland?

Answer 21

• high TSH and a high T3/T4

- low TSH and a low T3/T4