Chapter 18 (Thyroid Emergencies) Flashcards
Thyroid Gland
- butterfly shaped organ
- anterior to trachea
- 2-2.5 cm wide to 3.5 cm length
- produced thyroid hormones that determine:
1. metabolic rate
2. growth rate
3. other body mechanisms
Thyroxine
- stimulates gastrointestinal activity
- stimulates heart activity
- increases body temp
- increases respiration
- increases cellular metabolism
What is hypothyroidism?
not enough thyroid hormone produced
Hypothyroidism in the youth?
- cold intolerance
- weight gain
- dry skin
- constipation
- mental slowing
- physical slowing
Hypothyroidism in the elderly
same as the youth. more difficult to determine as these are symptoms are similar to other chronic diseases.
what is thyrotoxicosis?
too much thyroid hormone produced.
what is graves’ disease?
enlarged thyroid gland
- origin unknown
- hereditary
- autoimmune suspected
What is nodular goiter?
enlarged thyroid gland with multiple nodules.
inflammed:
2% of women
0.2% men
what are the signs and symptoms of hyperthyroidism?
- weight loss
- nervousness
- insomnia
- bulging eyes
- tremors
- sweating
- rapid heart rate
- diarrhea
what is hypothyroid?
synthetic thyroid hormone
- need to take for life
- usually levothyroxine
- dosage based upon weight, age, and cardiac status
what re the three methods of treatment of hyperthyroidism?
- surgery (last resort)
- antithyroid medications
- ablation therapy
Ablation therapy
- radioactive iodine to disable thyroid gland
- patient will be hypothyroid so need synthetic hormone replacement
treatment of surgery of hyperthyroidism
removal of thyroid gland
- last resort
- complications: hemorrhage, hypoparathyroidism, vocal chord paralysis
(treatment) antithyroid medications
- methimazole or propylthiouracil
- relapses usually occur so usually temporary treatment
- side effects: agranulocytosis and hepatitis
what are the thyroid emergencies?
- myxedema coma
- thyroid storm
what is myxedema coma?
- occurs when body unable to compensate for thyroid hormone deficiency due to some precipitating event
- usually patent not comatose- misnomers
- more common in males and individuals over 70.
- often occurs in winter months (hypothermia)
what are the signs and symptoms of myxedema coma?
- deterioration of mental state- confusion, apathy, depression, psychosis
- hypothermia (<95 F)
- hair loss
- facial conditions
signs and symptoms of myxedema coma?
- cool, dry skin with non-pitting edema
- bradycardia
- elevated BP early then lowered BP later
- seizures possible
treatment of myxedema coma
- normalize patient’s temp and respiration
- contact EMS immediately
- IV levothyroxine needed
treatment of myxedema coma
- mortality rate 30-60%
- position patient supinely
- maintain airway and circulation
- administer O2 4-6L/min
- monitor vital signs
Thyroid storm
- life threatening
- 10-50% fatal
- exacerbation of hyperthyroid state
what are the signs and symptoms of thyroid storm?
- exaggeration of hyperthyroid symptoms
- fever
- diaphoresis
- CNS- restlessness, confusion, anxiety, psychosis
signs and symptoms of thyroid storm
- GI symptoms- nausea, vomiting, diarrhea, juandice
- increase systolic BP
- widened pulse pressure
- Arrhythmias
treatment of thyroid storm
hyperthyroid treatment of medication, ablation therapy, or surgery will follow once the patient is stabilized
