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pharm test 4

ch. 30 thyroid and antithyroid agents

QuestionAnswer
thyroid secretes 3 hormones essential for proper regulation of metabolism -thyroxine (T4) -triiodothyronine (T3) -calcitonin
hypothyroidism cretinism: hyposecretion of thyroid hormone during youth leads to cretinism--> low metabolic rate, retarded growth & sexual development, possibly mental retardation
hypothyroidism myxedema: hyposecretion of thyroid hormone as an adult; decreased metabolic rate, loss of mental & physical stamina, weight gain, loss of hair, firm edema, yellow dullness of skin
hypothyroidism goiter: enlargement of thyroid gland; results from over stimulation by elevated levels of TSH (TSH is elevated b/c there is little or no thyroid hormone in circulation)
hypothyroidism common symptoms thickened skin, hair loss, constipation, lethargy, anorexia
Hyperthyroidism: affects multiple body systems, resulting in an overall increase in metabolism -diarrhea, flushing, increased appetite, muscle weakness, sleep disorders, altered menstrual flow, fatigue, palpitations, nervousness, heat intolerance, irritability
thyroid preparations -levothyroxine (synthroid, levoxyl): synthetic thyroid hormone T4 (MOST COMMON) -liothyronine (cytomel): synthetic thyroid hormone T3 -liotrix (thyrolar): synthetic thyroid hormone T3-T4 combined
thyroid preparation indications to treat all 3 forms of hypothyroidism: whether the problem is with the hypothalamus, pituitary gland, or thyroid gland
which is the preferred agent? levothyroxine b/c its hormonal content is standardized; therefore, its effect is predictable
S/E of synthroid would be anything you see with HYPERthyroidism -tachycardia, palpitations, angina, HTN, insomnia, tremors, headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss, sweating, heat intolerance, others **MOST COMMON adverse effect IS cardiac dysrhythmia
treatment of Hyperthyroidism radioactive iodine works by destroying the thyroid gland
antithyroid drugs thioamide derivatives: -methimazole (tapazole) -propylthiouracil (PTU)
nursing implications teach pt. to take thyroid agents once daily in the morning to decrease the likelihood of insomnia if taken later in the day
nursing implications: antithyroid agents -better tolerated when given with food -given at the same time each day to maintain consistent blood levels -never stop these meds abruptly -avoid eating foods high in iodine (seafood, soy sauce, tofu, & iodized salt)
when monitoring the lab values of a pt. who is taking antithyroid drugs, the nurse knows to watch for decreased WBC counts
the pharmacy has called a pt. to notify her that the current brand of thyroid replacement hormone is on back order. the pt. calls the clinic to ask what to do. Which is the best response by the nurse? "let me ask your physician what should be done, we will need to watch how you do if you switch brands"
when assessing the older adult pt., the nurse keeps in mind that certain nonspecific symptoms may represent hypothyroidism in older adult pts, such as: cold intolerance, depression
to help with the insomnia associated with thyroid hormone replacement therapy, the nurse should teach the pt. to take the dose first thing in the morning
when teaching a pt. who has a new prescription for thyroid hormone, the nurse should instruct the pt. to notify the physician if which adverse effect is noted? palpitations
Created by: lissy11