hyperthyroidism

Question 1

thyroid gland

Answer 1

-produces hormones T3 T4 calcitonin

Question 2

calcitonin/calcimere

Answer 2

DECREASES serum Ca by taking calcium out of the blood and pushing t back into the bone

Question 3

S/S of hyperthroid/Graves disease

Answer 3

-nervous
-weight loss
-sweaty/hot
-exophthalmos(bulging eyes,excess fluid)
-attention span decrease
-appetite increase
-irritable
GI fast
BP increased
-Thyroid enlarged
-increased workload on heart

Question 4

hyperthyroid diagnosis

Answer 4

• T3 T4 increased
• Thyroid scan/sonogram, fine needle aspiration/biopsy
• Pt must discontinue any iodine containing medication 1wk prior to scan

Question 5

Hyerthyroid treatment: anti-thyroids

Answer 5

propylthiouracil(PTU), Methimazole (Tapazole)

• stops the thyroid from making thyroid hormone
• used pre-op to stun the thyroid
• want pt to become euthyroid(=normal)

Question 6

hyperthyroid treatment iodine compounds:

Answer 6

potassium iodine(sski), strong iodine solution (lugol’s solution)

• decreases chance of bleeding
• decrease the size and vascularity of the gland
• give in milk,juice w/straw to avoid staining teeth

Question 7

hyperthyroid treatment beta blockers

Answer 7

Propanol(Inderal)

• decreases myocardial contractility
• could decrease cardiac output
• decreses HR, BP
• decreases anxiety (blocks release of epi/norepi)

Question 8

do u give beta blockers to asthmatics or diabetics?

Answer 8

Do not give beta blockers to asthmatics or diabetics/pt with COPD
-asthmatics can have a selective beta blocker

Question 9

hyperthyroidism treatment:radioactive iodine

Answer 9

-1 dose of radioactive iodine
-decreases size and vascularity & size of thyroid
-oral liquid or tablet given (rule out pregnancy first)
-DESTROYS thyroid cells
-follow radioactive precautions
(stay away from babies 24hr
no kissing 24hr)
watch for thyroid storm

Question 10

Thyroid storm(thyrotoxicosis,thyrotoxic crisis)

Answer 10

-hyperthyroism multiplied by 100 can lead to heart attack
could be rebound effect from post radioactive iodine
-thyroid storm is an EMERGENCY
-radioactive iodine is not only cause
-pt needs to be in ICU
-for hypocalcemia IV calcium at the bedside

Question 11

hyperthyroidism treatment Surgery

Thyroidectomy(partial/complete)

Answer 11

post op:

• teach pt how to support neck
• place personal items close to them
• Positioning: elevate HOB to decrease edema and suture tension
• check for bleeding/back of neck/ look for bruising
• Nutrition(pre/post op) need more calories
• assess for laryngeal nerve damage by listening for hoarseness
• could lead to vocal cord paralysis, if there is paralysis of both cords airway obstruct will require immediate trach
• teach pt to report c/o pressure
• must be a trach set at bedside
• assess for hypocalcemia due to parathyroid removal s/s not sedated rrigid muscles, seizure

Question 12

eye care in hyperthyroidism

Answer 12

• if pt can’t close eyes/ hypoallergenic tape may be used to prevent injury or irritation
• dark glasses for photosensitivity
• artificial tears to prevent drying of the eyes
• treatment does not correct any eye/vision problems

Question 13

what will TSH level look like in hyperthyroidism

Answer 13

TSH will be low and TH will be high