Chapter 18 Flashcards
What is the thyroid gland?
Butterfly-shaped organ that is located anterior to the trachea
Normal size is 2-2.5 cm width and 3-5 cm length
What is the action of thyroid hormones produced by the thyroid gland?
Determine metabolic rate
Growth rate
Other specific body mechanisms
What is euthyroid?
Term used to describe an individual with a normally functioning thyroid gland.
What is hypothyroidism (myxedema)?
Insufficient thyroid hormone is produced by the thyroid gland
What are some causes of hypothyroidism?
Autoimmune disorders (Hashimoto’s thyroiditis)
Pituitary tumors
Surgery
Irradiation
Patients with documented hypothyroidism should be asked which of the following questions?
Are they taking their medications
Is their dosage stabilized
Do they have routine blood work performed to insure adequate medication levels
True or False
In young individuals myxedema manifests as cold intolerance, weight gain, dry skin, constipation, and mental and physical slowing.
True
What is hyperthyroidism?
Too much thyroid hormone is produced by the thyroid gland
also known as thyrotoxicosis - result of a condition called graves’ disease
What is Graves’ disease?
disorder associated with enlarged thyroid gland, which will feel soft on palpation - hereditary in nature - autoimmune disorder
What is nodular goiter?
enlarged thyroid gland with multiple nodules - another cause of hyperthyroidism
What are some signs displayed by hyperthyroidism?
weight loss nervousness insomnia bulging eyes (exophthalmos) tremors increased sweating rapid heart rate diarrhea Opposite of hypothyroidism
What are the three ways that patients with hyperthyroidism are treated?
surgery
ablation therapy
antithyroid drugs
What is ablation therapy?
involves using radioactive iodine to disable the thyroid gland
What are some medications used for synthetic hormone replacement to control hyperthyroidism?
methimazole
propylthiouracil
True or False
When thyroid hormone levels become too low, the patient may experience a potentially life-threatening condition called myxedema coma
True
True or False
When thyroid hormone levels become too high, the patient will most likely experience a serious condition called thyroid storm.
True
What is myxedema coma?
Occurs when the body is unable to compensate for the severe deficiency of the thyroid hormones often because of some precipitating event
What can myxedema coma result from?
Undiagnosed hypothyroidism
incorrect treatment
precipitating factor such as trauma, infection or sepsis, hemorrhage, hypoglycemia, or surgery
True or False
Myxedema coma is more commonly found in individuals over 70 years of age and is rarely seen in individuals younger than 60.
True
What are some signs and symptoms of myxedema coma?
Deterioration of the patient's mental state: confusion, apathy, depression Hypothermia (< 95 dg) hair loss certain facial conditions: puffiness, macroglossia, ptosis, periorbital edema cool, dry skin with non pitting edema bradycardia changes in blood pressure with elevation in the early stages and lowered in later constipation seizures impaired mobility hypoventilation coma (rare)
What is the major goal when treating myxedema coma?
normalize patient’s temperature and maintain respirations
admit to the hospital as soon as possible
What is thyroid storm?
life-threatening emergency characterized by an exacerbation of hyperthyroid state; often result of undiagnosed thyroid disease; overzealous treatment of hypothyroidism; precipitating factor (trauma, infection, diabetic ketoacidosis, cerebrovascular accident, stress, toxemia of pregnancy)
What are some signs and symptoms of thyroid storm?
fever ( as high as 108) diaphoreses restlessness confusion anxiety psychosis gastrointestinal symptoms (nausea, vomiting, jaundice, diarrhea) tachycardia increased systolic blood pressure widened pulse pressure arrhythmias
What is the preferred treatment of thyroid storm?
ensure the patient is in comfortable position
administer oxygen 4-6 L/minute
monitor vital signs
The most accepted method for treating hyperthyroidism is
ablation therapy
Which of the following is a sign of thyroid storm?
Fever
All of the following are strategies for managing thyroid storm except one. Which one is the exception?
wrapping in blankets to increase body temperature
Hypothyroidism is characterized by
cold intolerance
The emergent condition arising from severe hypothyroidism is
myxedema coma
The most common medication a patient would take for hypothyroidism is
levothyroxine
All of the following are treatment management strategies for myxedema coma except
administering sedatives and tranquilizers
The hereditary autoimmune disorder whereby the individual has an increased level of thyroid hormone production is known as
graves’ disease
