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hyperthyroidism
pn 141 test 1 book: med surg nursing pg 338
| Question | Answer |
|---|---|
| aka | thyrotoxicosis |
| what is it | an excess production of thyroid hormone which increases the metabollic rate |
| who gets it more often | women and older adults |
| what is it caused by (3 things) | an autoimmune response, very large doses of thyroid medication, excess secretion of thyroid-stimulating hormone from the pituitary gland |
| as one ages, the increased metabollic rate places a strain on what body system | the CV system |
| if untreated what can it result in | cardiac dysrhythmias, heart failure |
| w/ an increased metabolism the person has an increased appetite; do they gain or lose weight | lose wt |
| s/s: endocrine | goiter |
| s/s: respiratory | SOB |
| s/s: GI | diarrhea, increased appetite, wt loss |
| s/s: MS system | weakness, fatigue |
| s/s: neurologic | hand tremors, nervousness, insomnia, emotional lability |
| s/s: sensory | blurred vision, excess tearing, exophthalmos (grave's disease) |
| s/s: CV system | HTN, tachycardia, dysrhythmias, palpitations |
| s/s: reporductive system: | amenorrhea, decreased fertility, decreased libido, impotence, |
| s/s: integumentary | fine, thin hair, warm/smooth/moist skin, nails separate from the nail bed |
| s/s: metabolic processes | intolerance to heat, diaphoresis |
| graves disease: is it an autoimmune disorder | yes |
| graves disease: most common cause of what | hyperthyroidism |
| graves disease: who gets it | women <40 yo |
| graves disease: what gland is enlarged; why | the thyroid gland; because an increased production of the thyroid hormone a |
| graves disease: what is exopthalmos | the eyes are pushed outward because of an enlargement of fatty tissue surrounding the eye. the sclera is visible above the iris. "unblinking stare" |
| graves disease: exopthalmos complications | unable to close the eyelid completely, corneal dryness, infection, and ulceration. |
| graves disease: does tx of graves disease reverse features of exopthalmos | no |
| thyrotoxic crisis: aka | "thyroid storm" |
| thyrotoxic crisis: what is it | an extreme state of hyperthyroidism (rare today) |
| thyrotoxic crisis: cause of it | untreated hyperthyroidism, infection, DKA, physical or emotional trauma, thyroid surgery. |
| thyrotoxic crisis: is it life threatening | yes |
| thyrotoxic crisis: s/s of it | high fever (>102 F), tachycardia, HTN, restlessness, tremors, confusion, delirium, coma, seizures |
| thyrotoxic crisis: tx | antithyroid medicaion give to decrease thyroid hormone production |
| thyrotoxic crisis: what med can actually increase thyroid hormone levels | aspirin |
| Tx: what is it focused on | reducing the production if TH and preventing or treating complications |
| how is it Dx | through H&P, lab values |
| what labs will be altered | elevated serum T3 and T4, decreased TSH levelsand increased radioactive iodine (RAI) uptake |
| meds: why are antityroid medications given | to reduce TH production |
| meds- antithyroid meds- how long does the therapeutic effect take | several weeks |
| radioactive therapy: what is it | radioactive iodine (I-131) given orally, is used to destroy thyroid cells so that they produce less thyroid hormone. |
| radioactive therapy: how long is Tx | about 6-8 weeks |
| radioactive therapy: what can happen after Tx | hypothyroid and need life long replacement |
| radioactive therapy: how long does it take the bldy to eliminate the radioactive iodine; how is it excreted | 2-3 day; in urine, saliva, and feces |
| radioactive therapy: side effects | some experience mouth and throat sryness for 2-3 days |
| surgery-subtotal thyroidectomy: what is it | the removal of part of the thyroid gland; the surgery leaves enough gland tissue to produce an adequate amount of thyroid hormone |
| surgery-subtotal thyroidectomy: who gets this surgery | pt with large goiters that cause breathing problems or swallowing problems, and pregnant wm who cannot be exposed to radiation therapy |
| surgery-total thyroidectomy: what is it | the complete removal of the thyroid gland |
| surgery-total thyroidectomy: why is it done | to treat cancer of the thyroid |
| surgery-total thyroidectomy: what life ong therapy is needed afterwards | hormone replacement |
| surgery-total thyroidectomy: before the surgery the pt should be in a _____ thyroid state | balanced (euthyroid) |
| surgery-total thyroidectomy: how is this balanced thyroid state accomplished | by giving antithyroid drugs to decrease the vascularity and size of the gland |
| surgery-total thyroidectomy: what are the five common complications of the surgery | |
| what hormone stimulates the thyroid gland | thyroid stimulating hormone (TSH) |
| What is needed in order to produce thyroid hormone (T3 and T4) | iodine |
| is there a goiter; why | yes ; eve nthough gland is not being stimulated; TH is still being produced in large amounts so the thyroid gland enlarges |
| is TSH high or low | low, bc there is no need to stimulate the thyroid gland |
| why is there an increase of diarrhea | b/c the parastolsis increases |
| what are beta blockers and calc. channel blockers used | to treat the high HR and BP |
| are thyroid hormone (T3 and T4) elevated or lowered | elevated |
| what does a radioactive iodine uptake test (thyroid scan) do | it determines how large the thyroid is |
| med: methimazole (tapazole): adverse reaction | numbness, Ha, loss of hair, rash, N/V, |
| med: methimazole (tapazole): use | hyperthyroidism; inhibits thyroid hormone synthesis (T3 and T4) |
| how long are pt on radioactive iodine | 6-12 weeks |
| radioactive iodine: what happens with this | absorbed by then destroys thyroid tissue |
| radioactive iodine: nursing care | Check fluids and urine for 12 hours, have a private room, no sharing and double flush for one week |
| thyroidectomy: why are calcium levels low | b/c pituitary is removed too |
| thyroidectomy: s/s of low calcium | tetany, chvosteks sign, trousseaus sign |
| thyroidectomy: why is the size of the thyroid gland reduced prior to surgery | to prevent thyroid storm |
| thyroid storm: what happens | when thyroid is removed it releases large amounts of TH and could cause it |
Created by:
jmkettel
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