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Metabolism
Thyroid
| Question | Answer |
|---|---|
| Thyroid Gland | -Gland that produces hormones that regulate the speed with which the cells/metabolism work |
| Thyroid Function | -Produces thyroid hormones: T3, T4 and calcitonin -When T3 and T4 is low, the pituitary gland releases more TSH -When T3 and T4 is high, the pituitary gland stops releasing TSH |
| Hyperthyroidism | -Too much T3 and T4 causing decreased TSH |
| Hyperthyroidism Causes | -Graves disease -Thyroiditis -Increased iodine intake |
| Hyperthyroidism Risk Factors | -Women over 60 -Type 1 diabetes mellitus -Family history -Medications -Infection -Surgery -Preeclamsia in pregnancy |
| Hyperthyroidism Symptoms | -Weight loss -Irritability/anxiety -Nervousness -Sensitivity to high temps -Shaking -Hair loss -Missed/light periods -Exopthalmus -Loose nails -Dyspnea -Palpitations |
| Hyperthyroidism Diagnosis | -Lab tests: thyroid function tests (increased T3 and T4, decreased TSH), CBC with diff, CMP, serum thyroglobulin level, antithyroid antibody test -Thyroid scan -Ultrasonography -ECG (commonly shows SVT) |
| Hyperthyroidism Treatment | -Drug therapy -Thionamides (Methimazole, PTU) -Beta-adrenergic blockers (Propranolol) -Radioactive iodine (RAI) therapy -Surgical Treatment -Total thyroidectomy -Subtotal thyroidectomy (partial removal) |
| Thyroid Storm/Crisis` | -Extreme state of hyperthyroidism -Life-threatening -Rapid increase metabolic rate (fever, tachycardia, systolic hypertension, n/v/d) -May be triggered by trauma, infection, DKA, pregnancy, RAI therapy, untreated hyperthyroidism |
| Thyroid Storm Treatment | -Maintain airway -Reduce fever -Oral anti-thyroid drugs -Admin sodium iodide solution -Propranolol -Glucocorticoids -Cardiac monitor -Frequent vitals, comfort measures, NS for dehydration |
| Hypothyroidism | -Not enough T3 and T4 causing increase in TSH |
| Hypothyroidism Causes | -Inflammation of the thyroid gland -Autoimmune diseases -Atrophy of the thyroid gland -Therapy for hyperthyroidism -Medications -Iodine deficiency -Hashimoto's -Postpartum thyroiditis |
| Hypothyroidism Risk Factors | -Women age 30-60 -Cancer -Family history -Autoimmune disease -Thyroid surgery -Medications -Pregnant/delivered within past 6months |
| Hypothyroidism Symptoms | -Extreme fatigue -Weight gain -Heavy periods -Cold intolerance -Poor memory -Constipation -Increased sleeping -Decreased libido -Bradycardia -Goiter -Depression |
| Hypothyroidism Diagnosis | Lab tests: thyroid function test (decreased T3 and T4, increased TSH), serum thyroglobulin level, antithyroid antibodies |
| Hypothyroidism Treatment | -Drug therapy -Hormone replacement of T4 (Levothyroxine) -Surgery -Removal of large goiter |
| Hypothyroidism in Infants | -Jaundice -Large, protruding tongue -Breathing difficulties -Hoarse crying -Umbilical hernia -Difficulty feeding -Constipation -Poor muscle tone -Sleepy -If not treated may cause severe developmental delay and physical delay |
| Hypothyroidism in Children/Teens | Same as adults but may also have: -Poor growth -Delayed puberty -Delayed development of permanent teeth -Delayed cognitive development |
| Myxedema Coma | -Untreated/poorly treated hypothyroidism -Rare/life-threatening -Mortality rate 60% -Heart muscle becomes flabby, chambers increase in size, decreased cardiac output -Caused by trauma, CNS depressants, failure to medicate, infection, exposure to cold |
| Myxedema Coma Treatments | -Maintain airway -NS or hypertonic saline -Levothyroxine IV -Glucose IV -Corticosteroids -Vitals frequently -Warm blankets -Neuro checks -Aspiration precautions |
| Hypothyroidism Assessment | -Assessment of the thyroid from an anterior and posterior position -Auscultation of the lobes of the thyroid -Assess thyroid gland for firmness (Hashimoto's) or tenderness (thyroiditis) |
| Hypothyroidism Nursing Interventions | -Promote rest -Protect against coldness -Avoid external heat exposure -Increase fluid intake -Manage respiratory symptoms -Pulmonary exercises |
| Hyperthyroidism Assessment | -Assess eyes (blurred vision, orbital pain, exophthalmos) -Assess sleeping/rest (insomnia) -Activity and Exercise (activity intolerance) -Metabolic nutrition (weight loss) |
| Hyperthyroidism Nursing Interventions | -Promote rest -Protect against heat -Educate patient to report any s/s of worsening disease or thyroid storm |
Created by:
NikkiLeigh83
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