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PathoPharm 2 > Ch 49 disorders of thyroid > Flashcards

Ch 49 disorders of thyroid Flashcards

1
Q

how are T3 and T4 made

A
  • hypothalamus makes TRH
  • anterior pituitary makes TSH
  • thyroid makes T3 and T4
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2
Q

term for normal thyroid

A

euthyroid

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3
Q

visible symptom of enlarged thyroid gland

A

goiter

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4
Q

treatment thyroiditis (3)

A
  • drug therapy
  • surgery
  • lifelong hormone replacement
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5
Q

chronic autoimmune condition caused by destruction of thyroid tissue by antibodies, goiter present

A

hashimotos thyroiditis

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6
Q

what is the thyroid responsible for in the body

A

regulating cellular metabolism

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7
Q

most common form of hyperthyroidism

A

graves disease

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8
Q

syndrome: physiological effects of hypermetabolism resulting from excess thyroid

A

thyrotoxicosis

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9
Q

S+S hyperthyroidism (graves disease) (6)

A
  • increased HR
  • decreased weight
  • diarrhea
  • fine straight hair
  • exophthalmos
  • heat intolerance
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10
Q

S+S acute thyrotoxicosis (6)

A
  • tachycardia
  • heart failure
  • hyperthermia
  • seizures
  • V/D
  • coma
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11
Q

how to distinguish graves disease from other forms thyroiditis/hyperthyroidism

A

RAIU test

graves has higher uptake of blood by thyroid (35-95%) and thyroiditis has uptake of less than 2%

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12
Q

how are TSH and T4 levels affected by hypothyroidism

A

increased TSH

decreased T4

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13
Q

how are TSH and T4 levels affected by hyperthryoidism

A

decreased TSH

increased T4

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14
Q

antithyroid med that blocks conversion of T3 to T4; preferred during pregnancy

A

propylthiouracil (PTU)

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15
Q

antithyroid med that blocks production of T3 and T4; contraindicated during pregnancy; high doses needed for thyroid storm

A

methimazole

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16
Q

antithyroid med that reduces vascularity around thyroid before surgery, reducing risk of hemorrhage (*administer with straw because permanently stains teeth)

A

lugol’s solution (contains iodine)

17
Q

antithyroid med that decreases heartrate and helps prevent palpitations

A

B blocker

18
Q

nutrition recommendations for hyperthyroid pts (3)

A
  • high calorie
  • high protein
  • reduce salt intake
19
Q

when would radioactive iodine therapy be recommended for hyperthyroid pts

A
  • treatment of choice for nonpregnant adults

- destroys thyroid tissue and limits thyroid hormone secretion

20
Q

3 reasons someone with hyperthyroidism would have thyroidectomy surgery

A
  • large goiter causing tracheal compression
  • lack of response to antithyroid therapy
  • thyroid cancer
21
Q

2 priority postop nursing considerations for pt with thyroidectomy

A
  • have suction and tracheotomy kit nearby

- monitor for hypocalcemia

22
Q

2 possible complications postop thyroidectomy

A
  • respiratory distress (laryngeal stridor or edema)

- hypocalcemia

23
Q

treatment thyroid storm (thyrotoxicosis) (5)

A
  • fluid replacement with isotonic saline infusion containing dextrose
  • continuous O2 and ECG monitoring
  • apply ice packs and cooling blankets
  • monitor ABGs
  • drugs (B blockers, antithyroid meds, iodine, glucocorticoids)
24
Q

possible causes thyrotoxicosis (3)

A
  • infection
  • thyroidectomy
  • trauma in pt with hyperthyroidism
25
Q

most common form hypothyroidism

A

hashimotos thyroiditis

26
Q

S+S hypothyroidism (9)

A
  • anemia
  • heart failure
  • constipation
  • cold intolerance
  • weight gain
  • slow speech
  • bradycardia
  • decreased LOC
  • FATIGUE
27
Q

important nursing considerations for med levothyroxine (4)

A
  • narrow therapeutic index
  • long half life
  • take on empty stomach 1 hr before first meal
  • IV push for severe hypothyroidism
28
Q

S+S myxedema (4)

A
  • dull puffy skin
  • coarse sparse hair
  • periorbital edema
  • prominent tongue
29
Q

progression of hypothyroidism to coma; medical emergency

A

myxedema coma

30
Q

S+S myxedema coma (4)

A
  • hypothermia
  • hypotension
  • hypoventilation
  • can lead to cardiovascular collapse
31
Q

possible causes myxedema coma (4)

A
  • infection
  • drugs (opioids, barbiturates)
  • exposure to cold
  • trauma
32
Q

med for thyroid hormone replacement

A

levothyroxine

PathoPharm 2 (33 decks)

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