Thyroid Flashcards by Melissa Johnson

What 3 hormones are produced by thyroid gland?

T3
T4
Calcitonin

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What does calcitonin do?

Decreases serum calcium levels by taking calcium out of the blood and pushing it back into the bone

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What do you need to make hormones?

Dietary iodine

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Thyroid hormone gives us ___

Energy

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Hyperthyroid = ?

Too much energy!—Graves Disease!!

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Hyperthyroid

Outlook

Nervous
Irritable
Attention span decreased

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Hyperthyroid

How is appetite?
Weight?

Appetite increases

Weight decreases

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Hyperthyroid

Body temp

Hot and sweaty

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Hyperthyroid

Eyes

Exophthalmos

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Hyperthyroid

Increases

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Hyperthyroid

BP and HR

Increases

*can have arrhythmias/palpitations

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Hyperthyroid

Thyroid size

Increase

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Hyperthyroid

Diagnosis…T4? TSH?

T4= Increased
TSH= Decreased

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Hyperthyroid

Dx test and teaching

Thyroid scan

No iodine med 1 week before scan and must wait 6 weeks to restart them

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Hyperthyroid

Other dx?

US
MRI
CT

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Hyperthyroid

Ex of a drug that has a lot of iodine levels?

Amiodarone (DOC for v-fib and v-tach)

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Hyperthyroid

Examples of anti-thyroids?

Methimazole

Propylthiouracil

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Hyperthyroid

What do anti-thyroids do?

Stop thyroid from making thyroid hormones

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Hyperthyroid

Anti-thyroids used ___ to stun thyroid

Preop

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Hyperthyroid

Anti-thyroids…we want client to become ____

Euthyroid

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Hyperthyroid

Example of iodine compounds?

Potassium iodine

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Hyperthyroid

What do iodine compounds do?

Decrease size and vascularity of the gland

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Hyperthyroid

ALL endocrine glands are very ___

Vascular (this is why its good to give iodine compounds for hyperthyroid—since iodine compounds decrease size and vascularity of gland)

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Hyperthyroid

How to give iodine compounds?

Mild or juice, WITH A STRAW (can stain teeth)

Hyperthyroid Why give BB?

Supportive therapy (propanolol) - Decrease myocardial contractility, CO, HR, BP - Situational anxiety

Hyperthyroid Do not give BB to who?

Asthmatics | Diabetics

Hyperthyroid Radioactive iodine therapy is given in how many doses?

One

Hyperthyroid How to give radioactive iodine therapy?

PO (liquid or tab)

Hyperthyroid Rule out what before giving radioactive iodine therapy?

Pregnancy

Hyperthyroid What does radioactive iodine therapy do?

Destroys thyroid cells (so you become hypothyroid)!

Hyperthyroid Radioactive precautions need to be followed for radioactive iodine therapy. Ex?

Stay away from babies for 1 week | Dont kiss anyone for 1 week

Hyperthyroid Watch for what during tx with radioactive iodine?

THYROID STORM! (if all thyroid cells aren't destroyed then a little bit that is left will overwork and that can cause a storm)

Hyperthyroid Surgery?

Thyroidectomy (partial or complete)

Hyperthyroid-Thyroidectomy Post op priority?

Hemorrhage

Hyperthyroid-Thyroidectomy Report what feelings?

Pressure

Hyperthyroid-Thyroidectomy Check for bleeding where?

Incision site, behind neck

Hyperthyroid-Thyroidectomy Assess for what?

Recurrent laryngeal nerve damage by listening for hoarseness

Hyperthyroid-Thyroidectomy Could lead to what?

Vocal cord paralysis

Hyperthyroid-Thyroidectomy When there is paralysis of both cords, what will require immediate trach?

Airway obstruction

Hyperthyroid-Thyroidectomy Keep what at bedside?

Trach set

Hyperthyroid-Thyroidectomy Why would we need a trach? (3)

- Swelling - Recurrent laryngeal nerve damage - Hypocalcemia

Hyperthyroid-Thyroidectomy Why would pt. have hypocalcemia?

PTH may have been removed

Hyperthyroid-Thyroidectomy S/s of hypocalcemia?

Rigid, tight muscles | NOT sedated

Hyperthyroid-Thyroidectomy Teach what?

How to support neck

Hyperthyroid-Thyroidectomy Keep what close?

Personal items

Hyperthyroid-Thyroidectomy HOB?

Elevated

Hyperthyroid-Thyroidectomy Nutrition?

Client needs more calories

HYPOthyroid Energy or no?

No energy--Fatigue!

HYPOthyroid Expression? Speech?

No expression | Speech slurred and slow

HYPOthyroid Weight? GI?

Weight increase | GI decrease

HYPOthyroid Hot or cold

Cold

HYPOthyroid Period?

Amenorrhea

HYPOthyroid You may be taking care of totally ___ client

Immobile

HYPOthyroid DX--T4? TSH?

T4: Decrease TSH: Increase

HYPOthyroid Tx?

Levothyroxine

HYPOthyroid Teaching about levothyroxine or liothyronine?

- Take on empty stomach - On med forever - Energy level will increase with these drugs

HYPOthyroid People with hypothyroidism tend to have _____

Increase BP/CAD!!! *worried about CV strain when you start these drugs

HYPOthyroid What are you worried about when starting levothyroxine or liothyronine?

MI!!! Many ppl with hypothyroidism also have CAD or increase BP.... so when starting these drugs, worried about too much strain that could lead to MI