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DSCC ENDOCRINE SYSTE

QuestionAnswer
What are the names of the cells that are located within the thyroid gland? 1)follicular-produces t4 & t3 2)parafollicular-produces and secretes thyrocalcitonin =(which lowers serum Calcium & phosphate levels)
What are the many functions of hormones in relation to the thyroid gland? fetal development,metabolic rate,pituitary secretion of GH & gonadotropin,protein,carb.,& fat metabolism,chronotropic & inotropic cardiac effects,RBC production,RR & drive,^ bone formation& dec.in bone resorption of calcium,insulin antag.
What are some noted features of the skin/nails/hair when assessment is done of thyroid function? hypopigmentation(hyper or hypo),rough,dry skin,yellow.cast(hypo),smooth,flushed skin(Hyper),dry,thick nails & hair(hypo),thin brittle nails/thin soft hair(hyper)
what are some noted features of the face/motor function/sensory function when assessment of the thyroid function is done? exophthalmos(hyper),inc.reflexes(hyper),dec.reflexes(hypo),peripheral neuropathy & parathesias(hypo)
Causes of Hyperthyroidism? graves Disease (autoimm.d/o)-antibodies (thyorid-stimulatin immunoglob)bind to thyroid gland which causes ^ in size & overproduction of thyroid hormones
Clinical Manifestations of GRAVES dz? (most common cause of hyper) thyrotoxicosis,goiter,exophthalmos,pretibial myxedema
Other causes of Hyperthyroidism? toxic multidular goiter caused by multiple thyroid nodles,women over 50.Clinical S/Sx:goiter(Yrs.),no exophthalmos or pretib.edema Exogenous hyperthyroidism-excessive use of thyroid replacement horm. Thyroid Storm/Crisis
What are the clinical manifestations of thyroid storm/crisis? All manifest.are more severe/life threat. hyperthermia 102-106,tachycard.,systolic htn,abd pain,vomit.diarrhea,agitation,restlessness>psychosis,delirium,seizures
What is the treatment needed for Thyroid storm/crisis? Cool without aspirin,replaces fluids (NS),insulin,electrolytes,relieve resp.distress,stabilize CV function,reduce TH synthesis (antithyroids,beta-blockers & don't give ASPIRIN & check Glucose!
Clinical manifestations of hyperthyroidism heat intol,diaphoresis,palpit.,chest pains,htn,tachycard,dyspnea,muscle wasting,weakness,fatigue,tremors,blurr.vision,photophobia,exophthalmos,n/v/d,abd pain,hunger,wt loss,amenorrhea,dec.fertility (fem)dec.lib/impot(male)fine thin hair,flushed moist skin
Clinical manifestations of hyperthyroidism in neonates? irritable,tachycard,HTN,voracious appetite & poor wt.gain,flushing,prominent eyes,& thyroid enlargement
Diagnostic Studies for Hyperthyroidism T3= 70-205 ng/dl (Inc), T4=4-12 mcg/dl(inc) Thyroid antibod.titer <1:100(high) TSH=2-10 uU/Ml(low in GRAVES,high in Sec.or Tert.hyperthyroid.) thyroid scan-uptake of iodine by thyroid (RAIU)-increased with hyperthyroid.ASSESS ALLERGIES r/o pregnancy!
Hyperthyroidism Management RAI therapy-given orally,results 6-8 wk,no with pregnancy,isolated for 3 days,plastic utensils,2 showers/day,separate toilet-flush twice can stay in toilet 96 days,may become hypothyroid-need lifelong TH replacement
Mild-To-Mod.Hyperthyroid meds beta-blocker(inderal),antithyroid(PTU)-take med q8h,no crowds/sick ppl,report dark urine,jaundice,bleeding Tapazole-notify md if suspect Pregnancy! may take sev.wk before pt.has therapeutic effects/teach pt.check B/P pulse before giving beta-block
SEVERE Hyperthyroid.meds (iodine agents):lugol's sol.,saturated sol of pot.iodide(sski) Remember to ck.allergies & administer 1 hr. after thionamide is given,watch for s/s of iodism:fever,rash,met.taste,mouth sores,sore throat,gi distress
Hyperthyroid Nursing Diagnosis Imbal.Nutriton less than Body requirements Hyperthermia Fatigue PC:HTN,Cardiac Fail,Hypertensive Crisis
Created by: bnix
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