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Endocrine I
Thyroid and Parathyroid
| Question | Answer |
|---|---|
| What three hormones does the thyroid gland produce/secrete? | T3, T4, and calcitonin |
| The _____ is located behind, close to, or embedded in the thyroid gland. It is responsible for producin/secreting ______. | Parathyroid Gland, Parathormone(PTH) |
| The thyroid plays a major role in regulating _____________. | Metabolism |
| Thyroid hormones increase metabolic rate, which _______ oxygen consumption and _____ production. | Increases, Heat |
| Thyroid hormones give you ________. | Energy |
| You have ______ in your diet to make thyroid hormones. | Iodine |
| Increase in thyroid hormones do what to your heart rate? | Increase (Tachycardia) |
| Why is levothyroxine (Synthroid)given? | Hypothyroidism |
| What does Synthroid do to the heart rate? | Increases |
| __________ disease is the most common type of hyperthyroidism. | Graves Disease |
| Why is goiter associated with hyperthroidism? | The pituitary releases to much PSH and the thyroid is overstimulated. |
| Why is goiter associated with hypothyroidism? | The thyroid is producing too much hormone. |
| Bulging of the eyes that is often seen with hyperthyroidism is called ______ and is due to accumulation of fluid behind the eyeballs. | Exopthalmus |
| After you have assessed the thyroid gland to be enlarged, what should your next action be? | Listen for a bruit |
| In a patient with hyperthyroidism, the radioactive iodine uptake should be___________ | Increased |
| In a patient with hypothyroidism, the radioactive iodine uptake shold be ___________ | Decreased |
| List a few examples of medications that must be discontinued one to two weeks prior to a radioactive iodine uptake test and explain why. | Iodine, MVI, cough syrups, because they contain iodine and can affect results. |
| PTU and Tapazole are antithyroid drugs which block the making of what? Must watch for signs of: | Thyroid Hormones(TH) Can cause agranulocytis and Thrombcytopenia; monitoe for s/s of infection, bleeding: monitor CBC |
| Potassium Iodide, Lugol's solution, SSKI are iodine preparations which inhibit the production and release of Thyroid Hormones. What is another use of these iodide solutions | Reduces size and decreases vascularity of thyroid preop. Less chance of hemorrhage and thyroid storm. |
| Why are Beta Adrenergic Blockers given to patients with hyperthyroidism? | Decrease sympathetic nervous systems: Cardiac, Tachycardia, palpations, nervousness, anxiety. Inderal |
| Why is radioactive Iodine therapy given to patients with hyperthyroidism? | Destroys overactive thyroid cells |
| Name two adverse affects to watch for in a person recieving radioactive iodine. | Hypothyroidism(destroys thyroid cells: usually need thyroid replacement) Thyroid Storm(overstimulation of the thyroid) |
| For patients undergoing a total thyroidectomy, what do you teach them regarding medication regimen? | They will have to take thyroid hormone replacement for life |
| Preop for a patient having a thyroidectomy, why do you want them in a euthyroid state? | Decrease vascularity(cance of hemorrhage) and decrease chance of thyroid storm(overstimulation during surgery) |
| Why is it important to assess speach after surgery? | Assess for laryngeal nerve damage, laryngeal nerve and vocal cords run very close to thyroid |
| After a thyroidectomy, what possition will your patient be in and why? | Semifowlers, 2 pillows to reduce edema |
| What has happened when a person who has had a throidecomy complains of tingling around the mouth, toes and fingers? | Low calcium, accidental removal of the parathyroids |
| If someone with hypothyroidism has a T3, T4, and TSH done, what would it show? Hyperparathyroidism has ____________levels of calcium (increase PTH) | Increased |
| Hypoparathyroidism has _____________levels of calcium (decrease PTH) | Decreased |
| Calcium and _____ have an inverse relationship. If you have an increase in calcium you will have a decrease in _____. | Phosphorus; phosphorus |
| _______ acts as a sedative. | Calcium |
| When will you see tetany (low calcium), muscle twitching, + Chovstecs and Trousseaus | Hypoparathyroidism(low calcium- irratability of muscles and nerves; hyperactive reflexes |
| After a thyroidectomy, what must be in the room at all times? | Trach tray, suction equipment, oxygen, and calcium gluconate |
| Low serum calcium levels _____ release of calcitonin to keep from lowering it more. | suppress |
| Elevated serum calcium levels ______ the release of calcitonin to help lower calcium levels | increase |
| Calcitonin makes strong bones by | Keeping calcium in bones and out of blood |
| PTH makes weak bones by | Pulling calcium from the bones into the blood |
| Pituitalery gland releases ______ from the _______ lobe. | TSH (Thyroid Stimulating Hormone), Anterior |
| Why does hyperthyroid cause an increase in RBCs? | Because of the increase in O2 consumption, RBCs are needed to carry O2. |
| Common type of hypothyroidism- | Hashimotos |
| Extreme hypothyroidism- | Myxedema |
| Most extreme hyperthyroidism- | Thyroid storm |
| T3 & T4 regulate | basal metabolic rate |
| when T3 & T4 levels are high | TSH release is inhibited |
| when T3 and T4 is low | TSH is released so thyroid gland will produce and secrete T3 & T4 |
| Dietary requirements for T3 & T4 production | food, water, protein, and iodine |
| Goiter causes | Lack of iodine, tumors, inflamation, excess iodine or lithium |
| Give ________and______for hypothyroidism. | Fluids and fiber |
| Why take thyroid hormones in the a.m.? | because they give you energy |
| When TH is given, monitor closely for.... | Angina, dyspnea, increased BP |
| TH may increase.... | Blood glucose, digitalis, and anticoagulants, so there is a risk for bleeding. |
| Myxedema manifestations | Hypothermic, decreased LOC, hypoventilation, acidosis, decreased glucose |
| T3 & T4 are low, TSH is | High |
| Hypoglycemia radioactive iodine uptake is | decreased |
| Don't take TH with | Food |
| pt and inr will_______ with use of TH | increase |
| Patients who have overused narcotics and sedatives are at risk for | Myxedema coma |
| mngmnt of myxedema | Maintain airway, hydration, levothyroxine, glucose IV, warm blankets, steroids |
| Thyrotoxicosis | s/s of hyperthyroidism |
| Hyperthyroidism causes increased metabolism which leads to | negative nitrogen ballance |
| too much TSH = | hyperthyroidism |
| Hyperthyroid=high T3 & T4, and _______ TSH | low |
| Radioactive iodine uptake is read | 2 to 4 hours, and 24 hours |
| wthith radioactive iodine uptake you should stop your meds containing iodine 1 week prior, why? | Because they affect the thyroid |
| Hyperthyroidism diet | increase calories, protein and carbs because of the negative nitrogen ballance |
| Drug therapy for hyperthyroidism | PTU, Tapazole, Beta Adrenergic Blockers, radioactive iodine therapy |
| PTU and Tapazole are antithyroid drugs they.... | may take several weeks to become affective |
| PTU and Tapazole can cause | Agranulocytosis and Thrombocytopenia |
| Agranulocytosis | Low WBCs- risk for infection |
| Thrombocytopenia | risk for bleeding (bruising/petichia) |
| potassium iodide, lugol's, SSKI are used preop to | inhibit synthesis and release of hormones, and decrease vascularity of the gland.Avoid anything containing iodine |
| Beta blockers (Inderal) don't do anything to the thyroid, but they help symptoms such as.... | sympathetic nervous system, nervousness, tachycardia, tremor, anxiety, heat intollerance |
| After radioactive Iodene therapy | precautions for three days, watch urine |
| What is the risk of radioactive iodine therapy? | to much thyroid destroyed, causes hypothyroidism. Overstimulation may cause tthyroid storm. |
| signs of iodine toxicity | swelling of buccal mucosa, excessive salivation, coryza, skin eruptions in the mouth. |
| coryza | head cold symtoms, mouth changes in taste etc. |
| hypocalcemia or tetany | reduced PTH |
| calcium gluconate | 1st line treatment for hypocalcemia (low PTH) |
| Acute thytoiditis | Bacterial, fungi, parasitic, tx with abx |
| subacute thyroiditis | viral, treat symptoms |
| Chronic thyroiditis/Hashimoto's disease | if not treated can cause hypothyroidism. cannot produce thyroid hormone so must be given as treatment. |
| Parathyroid Glands | Raise serum Calcium through negative feedback mechanism. |
| Hyperparathyroidism too much sedative | serum phos drops/ bones get brittle tx with calcitonin avoid thiazide diuretics give phoshates and Fosomax |
| parathyroidectomy | removal of 1 or 2 parathyroid glands keep calcium gluconate on hand in case of a drop in calcium. |
| Hypoparathyroidsm Calcium too low in the blood | Spasms, tetany, bronchospasms, hyper DTRs Tx with calcium gluconate, calcium, high calcium foods avoid milk give amphogel |
Created by:
sandjlambert1
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