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NUR 405 (Med Surg II) > Thyroid Disorders (Exam 3) > Flashcards

Thyroid Disorders (Exam 3) Flashcards

(42 cards)

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1
Q

Continuum of Thyroid Dysfunction

A

Euthyroid State

Hyperthyroidism — Thyroid Storm

Hypothyroidism – Myxedema Coma

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2
Q

Thyroid Storm is interchangable with

A

Acute thyrotoxicosis

Thyrotoxic Crisis

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3
Q

Thyroid Review

A

Thyroid gland is control by secretion of TSH by Pituitary gland

TSH stimulates release of T4 (thyroxine) (inactive)

T4 is converted into T3 (triiodothyronine) Active

T3 Activates and energises all cells of the body

TSH is the shut off valve

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4
Q

Goiter

A

Enlarged thyroid gland

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5
Q

Goiter can be a result of

A

Overactive or underactive thyroid

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6
Q

Hyperthyroidism disorder

A

Graves Disease (75%) (Autoimmune)

Toxic multo-nodular goiter

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7
Q

Hyperthyroidism Hormones (Graves)

A

Increase T3 & T4

Decrease TSH

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8
Q

Hypothyroidism

A

Hashimoto’s thyroiditis

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9
Q

Hypothyroidism Hormones (hashimotos)

A

Decrease T3 and T4

Increase TSH

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10
Q

Goiter Can be caused by

A

Thyroiditis

Benign thyroid Nodules

Malignancy

Iodine deficiency

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11
Q

Toxic Goiter

A

Goiter with HYPERthyroidism

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12
Q

Non-toxic Goiter

A

Goiter with normal thyroid levels

(autoimmune problem)

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13
Q

Iodine Deficiency

A

Iodine is needed for synthesis of thyroid hormones

ONLY thyroid can uptake iodine

Deficiency occurs in parts of the world where it is insufficient in the diet

HORMONES CAN NOT BE SYNTHESIZED

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14
Q

Iodine Containing Foods

A

Yogurt

Milk

Eggs

Iodized Salt

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15
Q

Hyperthyroidism: Clinical S/S

A

-Metabolism

-Increase HR - murmurs - dysrhythmias - angina - palps

-Increase RR - DOE

-Weight loss

-Increase peristalsis

-Diarrhea

-Memory lapses

-Short attention span

-Hair loss (alopecia)

-Palmar erythema (red palms)

-Fine silky hair

-Diaphoresis

-Warm - moist skin

-VITILIGO

-BRUIT over gland

-Goiter

-EXOPHTHALMOS (Bulging Eyes)

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16
Q

Thyrotoxicosis

A

Excess thyroid hormone in body

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17
Q

Acute Thyrotoxicosis - Thyrotoxic Crisis - Thyroid Storm

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A

Acute and severe (rare) (death rare when treat early)

Results from stressors in patient with pre-existing hyperthyroidism

Patient having thyroidectomy are at risk (manipulation of hyperactive thyroid)

18
Q

Management of Hyperthyroidism: Durgy Therapy

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A

Anti-thyroid Medication
-methimazole

Iodine therapy
-SSKI and Lugol’s solution

Beta Blocker

19
Q

Hyperthyroidism: Antithyroid Medicaiton

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A

Methimazole
-Improvement seen 1-2 weeks after start
-Results take 4-8 weeks

20
Q

Hyperthyroidism: Iodine Therapy

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A

SSKI and Lugol’s Solution

Used to prepare the patient for a thyroidectomy

Give rapidly in large dose: Inhibits T3 and T4 and decreases vascularity of thyroid gland.

Makes surgery easier and safer

21
Q

Hyperthyroidism: Beta-blockers

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A

Use for symptomatic relief of thyrotoxicosis

22
Q

Hyperthyroidism: Treatment of choice

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A

Radioactive Iodine Therapy 131

23
Q

T/F: 60% of people with hashimoto’s disease received Radioactive Iodine Therapy 131?

Study These Flashcards
A

False

People with graves disease get this therapy because the hyperactive thyroid uptakes the radioactive iodine

24
Q

Radioactive Iodine Therapy 131 is for

Study These Flashcards
A

Non pregnant adults

25
Radioactive Iodine Treatment 131
Taken po in solution or capsule without need for hospitalization Radioiodine is rapidly incorporated into thyroid and its beta emission result in extensive local tissue damage
26
Patient who undergo radioactive thyroid treatment will have to be on
Thyroid replacement for the rest of life their life because it has killed off their thyroid
27
How does it take before RIT 131 to take effect?
6-18 weeks
28
How long is patient radioactive after radioactive iodine therapy?
Radioactivity is gone within a few days
29
Radioactive Iodine Therapy 131: Precautions
Minimize direct contact for 2-3 days Double flush toilet Separately launder clothes / towels
30
Subtotal Thyroidectomy
Removal of large portion of the thyroid gland (90%) Hypothyroidism will occur if too much taken
31
Subtotal Thyroidectomy: Indications
For those who are not responsive to anti-thyroid therapy Those with very large goiters Possibility of malignancy
32
Endoscopic thyroidectomy is
less invasive and is used for small nodules
33
Subtotal Thyroidectomy: Postop
RISKY (around neck procedure) Assess patient for signs of hemorrhage Assess patient for tracheal compression
34
What to watch for post subtotal thyroidectomy
Irregular breathing Neck swelling Frequent swallowing Choking Blood on dressing Sensation of fullness at incsion site SERUM CALCIUM LEVELS
35
Is hoarseness an expected finding after subtotal thyroidectomy?
Yes for 3-4 days
36
What position should patient be in post subtotal thyroidectomy
Semi-fowlers with head on pillow Avoid extension or any tension on suture lines
37
Serum Calcium Concerns w/ Thyroid Removal
Tetany secondary to (accidental) hypoparathyroidism AMB… tingling in toes, fingers, around mouth, muscle twitching, apprehension Trousseau's / Chvostek's
38
Hypothyroid: Clinical S/S
SLOW Metabolism -Weight gain -Depression -Fatigue -Slow mentation -Slow speech -Somnolence -Low exercise tolerance -DOE -Anemia -Constipation -Cold intolerance -Hair loss -Dry skin -Goiter -Difficulty swallowing -MYXEDEMA
39
Myxedema
Term used to refer to changes seen in skin with prolong hypothyroidism Swelling is hard / non pitting Can be reversed with thyroid hormones
40
Myxedema Coma
Severe hypothyroidism with very low thyroid hormones levels Medical Emergency IV thyroid hormones and steroids given
41
What causes Myxedema Coma?
-HF -Stroke -Infections -Not taking thyroid medication -Certain drugs
42
Medical Management: Hypothyroidism
Levothyroxine (Thyroid hormone replacement) Monitor thyroid hormones levels and adjust as prn T3 / T4 = low w/ hypothyroid TSH: High when defect is in thyroid TSH: Low when it is in pituitary or hypothalamus Nutrition to promote weight loss

NUR 405 (Med Surg II) (66 decks)

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