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Care of Adult/Older Exam #3 (5701) > Hyper/Hypo Thyroidism > Flashcards

Hyper/Hypo Thyroidism Flashcards

(60 cards)

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1
Q

Hyperthyroidism

A
  • A sustained increase in synthesis and release of thyroid hormones by thyroid gland
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2
Q

Hyperthyroidism occurs more often in men or women?

A

women

-

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3
Q

Highest frequency in Hyperthyroidism is found in what age group?

A

20- to 40-year-olds

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4
Q

Common symptoms of Hyperthyroidism in a younger adult?

A

nervousness, irritability, weight loss, heat intolerance, warm/moist skin

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5
Q

Common symptoms of Hyperthyroidism in an older adult?

A

anorexia, weight loss, apathy, lassitude, depression, confusion

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6
Q

medical term for lack of energy?

A

Lassitude

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7
Q

Lassitude

A

medical term for lack of energy?

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8
Q

Cardiac symptoms of Hyperthyroidism in a younger adult?

A

tachycardia, palpitations, no HF

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9
Q

Cardiac symptoms of Hyperthyroidism in an older adult?

A
  • angina
  • dysrhythmia (esp. A-Fib RVr)
  • HF
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10
Q

Most common cause of Hyperthyroidism?

A

Graves’ disease-autoimmune

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11
Q

Causes of Hyperthyroidism?

A
  • Graves’ disease-autoimmune
  • Thyroiditis
  • Toxic nodular goiter
  • Exogenous iodine excess
  • Pituitary tumors
  • Thyroid cancer
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12
Q

Clinical syndrome of hypermetabolism resulting from increased circulating levels of T3, T4, or both

A

Thyrotoxicosis

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13
Q

Thyrotoxicosis

A

Physiologic effects/clinical syndrome of hypermetabolism resulting from increased circulating levels of T3, T4, or both
- heat intolerance
- weight loss
- palpitations
- weakness/fatigue

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14
Q

What two conditions occurring together is known as Grave’s disease?

A

Hyperthyroidism and Thyrotoxicosis

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15
Q

Causes of Grave’s disease?

A

An autoimmune disease where body attacks thyroid gland
- Insufficient iodine supply
- Infection
- Stressful life events interacting with genetic factors
- Cigarette smoking

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16
Q

General Signs and Symptoms Of Hyperthyroidism?

A
  • Weight loss-despite increased appetite
  • Nervousness-inability to concentrate
  • rapid pulse
  • heat intolerance
  • ↑ Sensitivity to stimulant drugs
  • Elevated basal temperature
  • Goiter
  • Ophthalmopathy
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17
Q

Protrusion of eyeballs from the orbits

A

Exophthalmos

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18
Q

Exophthalmos

A

Protrusion of eyeballs from the orbits

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19
Q

Cardiovascular System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Bruit over thyroid gland
  • Systolic hypertension
  • ↑ Cardiac output
  • Dysrhythmias
  • Cardiac hypertrophy
  • Atrial fibrillation
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20
Q

GI System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • ↑ Appetite, thirst
  • Weight loss
  • Diarrhea
  • Splenomegaly
  • Hepatomegaly
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21
Q

Integumentary System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Warm, smooth, moist skin
  • Thin, brittle nails
  • Hair loss
  • Clubbing of fingers
  • Diaphoresis
  • Vitiligo
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22
Q

Musculoskeletal System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Fatigue
  • Muscle weakness
  • Proximal muscle wasting
  • Dependent edema
  • Osteoporosis
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23
Q

Swelling and clubbing of the fingers associated with Grave’s disease?

A

Acropachy

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24
Q

Acropachy

A

Swelling and clubbing of the fingers associated with Grave’s disease

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25
Nervous System Signs and Symptoms/Complications of Hyperthryoidism?
- Fine tremors - Insomnia - Lability of mood, delirium - Hyperreflexia of tendon reflexes - Inability to concentrate
26
Reproductive System Signs and Symptoms/Complications of Hyperthryoidism?
- Menstrual irregularities - Amenorrhea - Decreased libido - Impotence - Gynecomastia in men - Decreased fertility
27
Diagnostics for Hyperthyroidism?
- Physical Assessment - Decreased TSH levels (<0.4mIU/L) - Elevated Thyroxine (free T4) - Radioactive iodine uptake test - Graves 35-95% uptake - Thyroiditis less than 2%
28
Causes of Thyrotoxic crisis or Thyroid Storm?
infection, trauma, or surgery with preexisting hyperthyroidism
29
S/S of Thyrotoxic crisis-thyroid storm?
tachycardia, HF, shock, hyperthermia (up to 106F), restlessness, n/v
30
Treatmentof Thyrotoxic crisis-thyroid storm?
decrease thyroid hormone, control fever, fluid replacement, decrease/eliminate stressors
31
Tx of Hyperthyroidism?
``` Antithyroid drugs Iodine Radioactive Iodine Therapy B-Adrenergic Blocker Surgical therapy Nutritional Therapy ```
32
Antithyroid drugs-inhibit the synthesis of thyroid hormone
Methimazole
33
Methimazole
Antithyroid drugs-inhibit the synthesis of thyroid hormone
34
Why is Iodine given to pts as treatment for hyperthyroidism?
Inhibit synthesis of T3 and -T4, block release of hormones
35
Inhibit synthesis of T3 and T4, block release of hormones
Iodine
36
B-Adrenergic Blocker
- Tx for thyrotoxicosis | - Blocks SNS, decrease tachycardia, nervousness, irritability, tremors
37
- Tx for thyrotoxicosis | - Blocks SNS, decrease tachycardia, nervousness, irritability, tremors
B-Adrenergic Blocker
38
Nutritional Therapy for Hyperthyroidism?
- High calorie diet (4-5K cal/day) - Six full meals - High proteins, carbs, minerals, and vitamin - Avoid caffeine
39
Preferred surgical procedure for Hyperthyroidism?
Subtotal thyroidectomy
40
Complications from surgical tx of Hyperthyroidism?
- Damage or removal of the parathyroid gland may cause: - Hypoparathyroidism and hypocalcemia - Hemorrhage - Infection - Laryngeal nerve damage - Tracheal compression
41
Harsh vibratory sounds heard with respirations following surgical tx of hyperthyroidism?
Laryngeal stridor
42
Post-op Nursing Assessment/Interventions surgical tx of hyperthyroidism?
- Vitals Q 2 hours - hemorrhage - tracheal compression - Frequent swallowing - Sensation of fullness at incision site - Blood on dressing - Semi-fowlers position-support neck, avoid hyper extension - assess for Laryngeal Stridor - Hypocalcemia for 72 hours - Treat pain
43
Signs of a tracheal compression following surgical tx of hyperthyroidism?
- Frequent swallowing - A sensation of fullness at the incision site - Blood on dressing
44
Post-op Nursing Teaching for surgical tx of hyperthyroidism?
- C&DB - Leg exercises - Support head manually while turning in bed - ROM neck exercises - Decrease caloric intake, - Decrease exercise - avoid high temps - life long thyroid replacement
45
Discharge Teaching | Subtotal thyroidectomy?
- Monitor for signs of hypothyroidism - Will not take a thyroid replacement - Need some iodine – normal use of iodized salt - Regular exercise - Avoid extreme environmental temperatures - Decrease calorie intake - Regular follow-up care
46
Discharge Teaching Total thyroidectomy?
- Will be on a lifelong thyroid replacement - Decrease calorie intake - Regular follow-up care
47
most common cause | of Hypothyroidism world wide?
Iodine deficiency
48
Causes of Hypothyroidism
- Insufficient circulating thyroid hormone - Primary-destruction of thyroid tissue or defective hormone replacement - Secondary-pituitary disease - treatment of hyperthyroidism - Iodine deficiency
49
Secondary Hypothyroidism is cause by?
pituitary disease
50
risk factors for developing Hypothyroidism?
- Female - white ethnicity - advancing age - type 1 diabetes, - Down syndrome - family history - goiter - previous hyperthyroidism, previous radiation treatment
51
S/S of Hypothyroidism
- NO symptoms to classic symptoms - Fatigue, muscle weakness, and edema - Cold, dry skin - Hair loss - Constipation - Cold intolerance - Impaired memory and confusion - Weight gain - Lethargic, lacks initiative, Slow speech, personality changes - Brittle nails - Hoarseness - Menorrhagia
52
Cardiovascular System Signs and Symptoms/Complications of Hypothyroidism?
- ↓ Cardiac contractility and output - ↑ Serum cholesterol and triglycerides - Anemia
53
Diagnostics of Hypothyroidism?
- TSH - ↑if thyroid function is ↓ - ↓ if problems with pituitary gland or hypothalmus - ↓ Thyroxine (free T4) - ↑ Cholesterol & triglycerides - ↓ RBCs
54
Treatment of Hypothyroidism?
- Levothyroxine (Synthroid) - REPORT HR > 100 bpm or CP IMMEDIATELY - Life long therapy – take in AM on empty stomach
55
Levothyroxine (Synthroid) side effects?
- weight loss - nervousness - tremors - insomnia
56
Complications of Hypothyroidism?
- Mental sluggishness, drowsiness and lethargy progress gradually or suddenly to impairment of consciousness or coma - Myxedema Coma
57
s/s of Myxedema Coma
- low temp - hypotension - hypoventilation - puffiness - periorbital edema - mask-like effect
58
Treatment for Myxedema coma?
- Monitor cardiac function - Monitor core body temperature - Mechanical respiration support - IV hormone replacement
59
Patient presents with diagnosis of hypothyroidism, low temp, hypotension, hypoventilation. What condition is expected?
Myedema coma
60
s/s of overdose of hypothyroidism treatment?
- orthopnea,l - dyspnea - rapid pulse - palpitations, - nervousness - insomnia

Care of Adult/Older Exam #3 (5701) (8 decks)

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