ATI: Chapter 78 - Hyperthyroidism Flashcards
The thyroid gland produces three hormones
triiodothyronine T3
thyroxine T4
thyrocalcitonin (calcitonin)
Secretion of T3 and T4 is regulated by the _____ pituitary gland through a negative feedback mechanism.
anterior
When serum T3 and T4 levels decrease, ______ is released by the anterior pituitary. This stimulates the thyroid gland to secrete more hormones until normal levels are reached.
thyroid stimulating hormone (TSH)
T3 and T4 affect all body systems by regulating overall body _______, energy production, and controlling tissue use of fats, proteins, and carbohydrates.
metabolism
______ inhibits mobilization of calcium from bone and reduces blood calcium levels.
Calcitonin
Dietary intake of protein and ______ is necessary for the production of thyroid hormones.
iodine
Hyperthyroidism is a clinical syndrome caused by excessive circulating _____.
thyroid hormones
Because thyroid activity affects all body systems, excessive thyroid hormone exaggerates normal body functions and produces a ________.
hypermetabolic state
Advise the client with hyperthyroidism to take all _____ as directed.
medications
Advise the client with hyperthyroidism to check with the provider to taking _______ medications.
OTC
Advise the client with hyperthyroidism to keep all the ______.
follow up apppointments
Advise the client with hyperthyroidism to adjust diet to _____ metabolism when needed.
increase
Advise the client with hyperthyroidism to seek measures to _____ stress, and get test as needed.
reduce
Advise the client with hyperthyroidism to notify the provider of fever, increased restlessness, ______, and chest pain.
palpitations
_____ disease is the most common cause of hyperthyroidism. Autoimmune antibodies result in hypersecretion of thyroid hormones.
Graves
The autosomal recessive trait for grave’s disease is passed to _____.
females
Toxic nodular goiter, a less common form of hyperthyroidism, is caused by overproduction of thyroid hormone due to the presence of _____.
thyroid nodules.
Exogenous hyperthyroidism is caused by _______ of thyroid hormone.
excessive dosages
An expected finding of hyperthyroidism is nervousness, irritability, hyperactivity, emotional lability, decreased attention span, cries or laughs without cause, change in ______ or ______ status.
mental or emotional
An expected finding of hyperthyroidism is weakness, _____, and exercise intollerance.
easy fatigability
An expected finding of hyperthyroidism is muscle ____.
weakness
An expected finding of hyperthyroidism is heat _____
intollerance
An expected finding of hyperthyroidism is weight changes (usually _____) and increased appetite.
loss
An expected finding of hyperthyroidism _______ and interrupted sleep.
insomnia
An expected finding of hyperthyroidism is frequent stools and _______.
diarrhea.
An expected finding of hyperthyroidism is menstrual irregularities (_____ or decreased menstrual flow) and decreased fertility.
amenorrhea
An expected finding of hyperthyroidism an increased ______ initially in both men and women, followed by a decrease as the condition progresses.
libido
An expected finding of hyperthyroidism is warm, sweaty, _____ skin with velvety smooth texture.
flushed skin
An expected finding of hyperthyroidism the hair ______ and develops a fine, soft, silky texture.
thins
An expected finding of hyperthyroidism includes _____, hyperkinesia, hyperreflexia.
tremor
With Grave’s disease and expected finding is _______ due to edema in the extraocular muscles and increased fatty tissue behind the eye.
exophthalmos
is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves’ disease)
An expected finding of hyperthyroidism includes blurred or double vision and ______ of the eyes due to pressure on the optic nerve.
tiring
An expected finding of hyperthyroidism includes ______, sensitivity to light.
photophobia
An expected finding of hyperthyroidism is _____ tearing and bloodshot appearance of eyes.
excessive
An expected finding of Grave’s disease is ______: dry waxy welling of the front surfaces of the lower legs that resembles benign tumors.
pretibial myxedema
An expected finding of hyperthyroidism is eyelid _______: movement of the eyelid is delayed when the eye moves downward.
retraction (lag)
An expected finding of hyperthyroidism is ________: upper eyelid pulls back faster than the eyeball when the client gazes upward.
globe (eyeball) lag
An expected finding of hyperthyroidism is hair _____ or ____.
thinning or loss
An expected finding of hyperthyroidism is a mass called a _____.
goiter
An expected finding of hyperthyroidism is a _____ over the thyroid gland.
bruit
An expected finding of hyperthyroidism is elevated systolic blood pressure and widened _____.
pulse pressure
An expected finding of hyperthyroidism is ______, palpitations, and dysrhythmias.
tachycardia
An expected finding of hyperthyroidism is a breathing issue called _____.
dyspnea
An expected finding of hyperthyroidism in older adult clients are often more ____ than those in younger clients.
subtle
Occasionally an older adult client who has hyperthyroidism will demonstrate apathy or ______ instead of the more typical hypermetabolic state.
withdrawal
Older adult clients who have hyperthyroidism often present with heart failure, angina, and _____.
atrial fib
Lab tests for hypothyroidism
Serum TSH test
Free T4 index, T4 (total) T3
Thyroid-stimulating immunoglobulins
Thyrotropin receptor antibodies
Diagnostic procedures
ultrasound
electrocardiogram
radioactive iodine uptake
In the presence of Graves’ disease the serum TSH test will so _______ levels.
decreased
The serum TSH test can be _______ in secondary or tertiary hyperthyroidism.
elevated
With the Free T4 index, T4 (total) T3: in the presence of hypothyroidism the levels will be ______.
elevated
With the thyroid stimulating immunoglobulins with normal types of hyperthyroidism the levels are _______ and with Grave’s disease the levels are ______.
normal
elevated
Thyrotropin receptor antibodies test will show an _______ most indicative of Graves’ disease.
elevation
An _______ is used to produce images of the thyroid gland and surrounding tissue.
ultrasound
An ______ is used to evaluate the effects of excessive thyroid hormone on the heart (tachycardia, dysrhythmias). ______ changes include atrial fibrillation and changes in the P and T waves.
electrocardiogram
ECG
_______ test is a nuclear medicine test that clarifies size and function of the gland. It is contradinicated in pregnant women.
radioactive iodine uptake
Before a radioactive iodine uptake test assess for an allergy to ______ or _________ should be completed prior to this test.
iodine, shellfish
The uptake of radioactive iodine, administered orally ______ prior to the test, is measured.
24 hours
An ________ uptake is indicative of hyperthyroidism with the radioactive iodine uptake test.
elevated
Confirm that the client is not _____ prior to the scan.
pregnant
Take a med history to determine the use of ______.
iodides
Recent use of contrast media and oral contraceptives can cause ________ serum thyroid hormone levels.
falsely elevated
Severe illness; malnutrition; and the use of aspirin, corticosteroids, and phenytoin sodium can cause a _____ in serum thyroid hormone levels.
false decrease
Inform the provider if the client received any iodine contrast ______.
recently
Advise the client to avoid foods high in iodine for ______ prior to the test.
1 week
Suggest that the client use _______, and avoid fish, shellfish, and medications that contain iodine.
noniodized salt
Minimize the client’s energy expenditure by assisting with activities as necessary and by encouraging the client to alternate periods of activity with ___.
rest
Promote a _____ environment.
calm
Assess mental status and _____ ability. Intervene as needed to ensure safety.
decision making
Monitor nutritional status. Provide increased calories, _______, and other nutritional support as necessary.
protein
Monitor ______ and the client’s weight.
I&O
Provide ______ for a client who has exophthalmos.
eye protection
patches, eye lubricant, tape to close eyelids
Monitor vital signs and ______ parameters.
hemodynamic
Reduce room ______.
temperature
Provide cool shower/sponge bath to promote _____.
comfort
Provide ______ changes as necessary.
linen
Report a temperature increase of ____ or more to the provider immediately, because this is indicative of an impending thyroid crisis.
1 F
Monitor ECG for ______.
dysrhythmias
Assure the family that any abrupt changes in the client’s ______ are likely disease related and should subside with anti thyroid therapy.
behavior
Avoid excessive ______ of the thyroid gland.
palpation
Administer _______ medications.
antithyroid