Thyroid Disorders

Question 1

T3 and T4 action

Answer 1

Increased metabolism
Increased HR and RR
Increased in glucose intake into cells > decreased blood glucose

Question 2

Calcitonin

Answer 2

Secreted to decrease Ca+ levels in blood

Question 3

Parathyroid Hormone

Answer 3

Stimulates Ca+ to go from the bones to the blood

Stimulated renal absorption of Ca+

Question 4

If a pt. has parathyroid removed what are they are risk for?

Answer 4

Hypocalcemia

Question 5

Hypothalamus releases:

Answer 5

Thyroid Releasing Hormone

Question 6

Pituitary gland releases:

Answer 6

Thyroid Stimulated hormone

Question 7

Eeyore is which exemplar?

Answer 7

HYPOthyroidism

Very slow, sluggish

Question 8

Tigger is which exemplar?

Answer 8

HYPERthyroidism

Fast, tall and skinny

Question 9

Hashimoto’s Thyroiditis

Answer 9

Autoimmune disease that causes hypothyroidism

Question 10

Iodine deficit causes:

Answer 10

Hypothyroidism

Question 11

Which med can cause hypothyroidism?

Answer 11

Lithium

Question 12

What is lithium a Tx for relating to thyroid?

Answer 12

Hyperthyroidism

Question 13

Manifestations of Hypothyroidism

Answer 13

Fatigue
Weight gain
Increased sleep
Deceased appetite
Susceptibility to cold temp
Decreased HR, RR
Decreased cardiac contractibility
Decreased GI motility
Hair loss

Question 14

Myxedema

Answer 14

fluid collection associated with generalized non-pitting edema

Question 15

Lab want to monitor with hypothyroidism

Answer 15

T3 - low
T4 - low
TSH - elevated in primary

Question 16

Tx for hypothryoidism

Answer 16

Levothyroxine

Question 17

Levothyroxine

Answer 17

Take in AM on empty stomach
Use caution w/ cardiovascular pt.
Must take lifelong
Thyroid levels need to be monitored when med adjusted

Question 18

Myxedema Coma Signs and Sypmtoms

EXTREME HYPOTHRYOIDISM

Answer 18

Hypoxia
CO2 retention - Resp. acidosis
Hypoventilation
Low HR
F and E imbalances
Hypothermia
Hypoglycemia
Hyponatremia - b/c excess fluid

Question 19

Myxedema Coma Assess

Answer 19

Hyponatremia
Hypoglycemia
Prolonged QT interval
Cool extremities

Question 20

Tx for hyponatremia

Answer 20

Water restriction
Spironolactone
Oral Na+ supplement

Question 21

Pt. with Myxedema Coma is prescribed opioid for pain. What should the nurse do?

Answer 21

Myxedema Coma pt. are extremely sensitive to sedatives, analgesic, and anesthetics b/c slow metabolism - question prescription

Question 22

Myxedema coma is a severe complication of what disorder?

Answer 22

Hypothyroidism

Question 23

Tx for Myxedema Coma

Answer 23

IV levothyroxine
Support airway
Tx hyponatremia
Tx bradycaria - Atropine
Warming blankets
Fluid management

Question 24

Grave’s disease

Answer 24

Autoimmune disease that causes Hyperthyroidism

Question 25

Manifestation of Hyperthyroidism

Answer 25

``` Exothalamos Incresed HR - dysrhythmias Heat intolerance Fatigue Nervousness Insomnia Weight loss Increased appetite Hair loss ```

Question 26

Lab data for hyperthyroidism

Answer 26

T3 - elevated T4 - elevated TSH - decreased (primary) increased (secondary)

Question 27

Goiter is caused by what hormone?

Answer 27

Increased TSH

Question 28

Meds for Hyperthyroidism

Answer 28

Beta-blockers - control HR Anti-Thyroid agents - Methimazole and Lithium carbonate Glucocorticoids Iodine

Question 29

Possible Surgical complications for Hyperthyroidism

Answer 29

Airway compromise Hemorrhage Hypocalcemia Damage to lyngeal nerve

Question 30

Iodine-Potassium Tx

Answer 30

Decrease production of thyroid hormone and decrease blood flow to thyroid gland

Question 31

Surgical management for Hyperthyroidism

Answer 31

Thyroidectomy | Could potentially remove parathyroid

Question 32

Signs of Hypocalcemia

Answer 32

``` Trousseau and Chvostek's Sign Excitability of nerves and muscles Muscle spasms Dysphagia Wheezing Bronchospasms ```

Question 33

Tx for Hypocalemia

Answer 33

IV calcium gluconate | Oral supplements

Question 34

Signs the pt. is have a throat hemorrhage after thyroidectomy?

Answer 34

Repeated swallowing when not drinking or eating anything

Question 35

Tx for hemorrhage or airway compromise after thyroidectomy

Answer 35

Trach tray at bedside | Suction setup

Question 36

Complication of Hyperthyroidism:

Answer 36

Thyroid Storm

Question 37

Manifestation of Thyroid Storm | EXTREME HYPERTHYROIDISM

Answer 37

``` Tachycardia Fever High Systolic HTN Abd pain LOC changed ```

Question 38

Tx for Thyroid Storm

Answer 38

Glucocorticoids Airway management and IV fluids **** Beta-blockers Cooling blankets

Question 39

What are the nurse's priorities when a pt. is having a thyroid storm?

Answer 39

Airway Management | IV fluid resuscitation

Question 40

Why give a pt. with a thyroid storm glucocorticoids?

Answer 40

Glucocorticoids decreased conversion of T4 to T3 | Decreases TSH

Question 41

What should the nurse monitor for in a pt. with thyroid storm?

Answer 41

Cardiac probs Seizures - seizure precautions Respiratory complications