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Endocrine I

Thyroid and Parathyroid

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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