Hyperthyroidism

Question 1

What is the Primary cause of hyperthyroidism? Most common?

Answer 1

Grave’s disease

Diagnostics: High T3, T4
Low TSH

Question 2

What is the secondary cause of hyperthyroidism?

Answer 2

Thyroid adenoma (cancer)

Diagnostics: HIGH TSH, T3, T4

Question 3

What are the S/S of hyperthyroidism?

Answer 3

HIGH BP/HR (murmur, palpitations)
Weight loss d/t increased metabolism
Heat intolerance (always hot)
Finger clubbing, brittle nails
Tremors
Menstrual changes (amenorrhea)
Exophthalmus
Goiter
Anxious, nervousness, insomnia
Splenomegaly/hepatomegaly

Question 4

What is the diet?

Answer 4

High calories + protein + carb
6 full meals a day + snack
no caffeine
no spicy / highly seasoned foods

Question 5

What is the treatment?

Answer 5

Antithyroid meds (first line) : Methimazole
Beta blockers “LOLs”: for HIGH BP/HR
Radioactive iodine:
Stay away from children 2-4 days
Do not share toothbrush/plates/utensils
Flush toilet 3x

Question 6

Subtotal Thyroidectomy complications

Answer 6

Subtotal: Thyroid storm
Injures glands, triggers release of hormones

Question 7

Total thyroidectomy complications

Answer 7

Injury to parathyroid = hypocalcemia = tetany = resp. failure

Laryngeal nerve injury = hoarseness = resp. distress

Hemorrhage = airway restriction

Question 8

Thyroidectomy post op care

Answer 8

Position pt SEMI FOWLERS
Support head & neck w/ pillows
Have IV calcium gluconate + trach kit
Initiate seizure precautions
Assess for STRIDOR + HYPOCALCEMIA

Question 9

What is the role of calcium

Answer 9

A thyroidectomy can cause HYPOCALCEMIA
Monitor for TETANY that can close the airway
Chvosteks sign: cheek twitch
Trousseaus sign (twitch w/ BP)

Question 10

Thyrotoxicosis (thyroid storm)

Answer 10

Life threatening, excessive amount of hormones released
Severe tachycardia
HTN
HF
Shock
Hyperthermia
agitation/ seizures
Delirium/coma