Endo Flashcards
Thyroid Gland produces 3 hormones T3 -what is the synthetic version? T4 -what is the synthetic version? Calcitonin
Dietary Iodine is needed to make
Thyroid hormones gives us?
Triiodothyronine, more potent
- Liothyronine
Thyroxine
-Levothyroxine
Calcitonin decreases calcium by taking calcium out of the blood and pushing it back into the bone
Hormones
Energy
Hyperthyroidism
Nervous and Irritable Attention Span Appetite and weight Sweaty/Hot GI Bp and pulse Thyroid size is Arryhthmia/palpitations Exophthalmos
Produces too much energy. Aka Grave’s disease
Nervous because they have increased tachycardia and they are Irritable
Attention Span is decreased because they cant focus much
Increased Appetite but decreased weight due to increasee metabolism
Sweaty because they have increased energy and they have intolerance to heat
In GI they have diarrhea, increased bowel sounds because they have too much energy
Bp and pulse are increased
Increased
Arrythmia / palpitations is present in Hyperthyroidism, that is why thyroid storm is an emergency
Exophthalmos is bulging eyes
Diagnosis of Hyperthyroid
T4 is
TSH is
Thyroid scan is
-1 week prior and 6 weeks
Ultrasounds,CT,MRI
T4 is increased but TSH is decreased
The thyroid scan is BIG and GLOWING
- must discontinue any iodine containing meds and must wait 6 weeks to restart meds
These are more commonly used
Amiodarone
Is an antiarrhythmic drug, that contains high level of iodine
Treatment for Graves
Anti-thyroids(methimazole,propylthiouracil)
- stops the
- Pre Op
- euthyroid
Iodine compounds: POTASSIUM IODINE, like
- vascularity and size
- stains teeth
Betablockers
- Myocardial contractility
- BP and HR
- Anxiety
- asthmatic or diabetics
- epi and norepi
They Stop thyroid from making thyroid hormone
It is used Pre-op to stun the thyroid
Goal is to become Euthyroid( normal )
SSKI and Lugol’s Solution
Vascularity and Size of the thyroid gland is decreased. All endocrine Glands are very Vascular
It must be given with milk or juice and use a straw because ot stains teeth
Betablockers decreases myocardial contractility . Which decreases BP and HR
Anxiety is decreased when taking beta blockers
DONT give to patients with asthma or diabetics they could precipitate an attack
Beta blockers dont release epi and norepi
Treatment for Graves
Radioactive iodine therapy
- dose
- route
- pregnancy
- destroys
- radioactive precautions
- rebound effect is
One dose is needed and is given PO (either liquid or tablet form)
Must rule out pregnancy first
It destroys thyroid cells, hypothyroidism is expected
Stay away from babies for 1 week and dont kiss anyone for 1 week. Must think: Unsealed Radiation
The rebound effect of radioactive therapy is Thyroid Storm, this is an emergency situation could lead to heart attack.
Thyroidectomy (partial/complete)
Post op:
Priority is
Must report
Where to check for bleeding?
Assess for recurrent laryngeal nerve damage by listening for
Paralysis of vocal cords
Could lead to hypocalcemia
Support neck
Personal items
Position
Nutrition
Priority is hemorrhage.
Must report feelings of pressure on neck
Behind the neck and Incision site
Hoarseness and weak voice
Paralysis of vocal cords could lead to airway obstruction, immediate trach is needed
Could lead to hypocalcemia due to accidentally removing the parathyroid
Must be taught how to support the neck using pillows
Personal items must be put close to them to avoid stretching
HOB elevated to decrease edema
Nutrition client needs more calories pre and post
Hypothyroidism is
S/S:
No energy Fatigue No expression Speech is Weight and GI Hot or Cold?
Treatment: Synthetic t3 and t4 Taken on a Take meds forever? BP and HR
Decreased in T4 and Increased in TSH. Aka MYXEDEMA
If hyperthyroidism is too much energy, hypothyroidism has no energy because thyroid gives us Energy
The client is fatigue due to low energy
They dont have energy to even move face
Speech is Slow
Weight is increased because GI is Slow or decreased metabolism leading to constipation
They are cold intolerance, but must NOT pick a ☆☆HEATING PAD
T3 - liothyronine ( cytomel) and t4 - levothyroxine (synthroid)
Taken on a empty stomach
Yes, they take these meds lifetime
If they take these meds their BP and HR will increase because energy levels go UP
Hypothyroidism is same as S/S of
Hyperthyroidism is same as S/S of
Depression
Manic
PTH or Parathormone
Hyperparathyroidism
-client is
Hypoparathyroidism
- client is
- treatment
Pulls calcium from the bone and puts it in the blood. Increases serum calcium
Hyperparathyroidism is too much PTH, hypercalcemia, hypophosphatemia
- client is sedated
Hypoparathyroidism is not enough PTH, hypocalcemia, hyperphosphatemia
- client is not sedated
- phosphate binding drugs
Adrenal glands is needed for
2 parts are
STRESS
Adrenal cortex and Adrenal Medulla
Adrenal Medulla contains
Pheochromocytoma
S/S: Bp and HR Palpitations Flushing or Headache?
It is diagnosed by
- epi norepi
- VMA and MN(24 hour urine)
Foods that alter VMA and MN
“ BBVaCaF “
Treatment:
Epinephrine and Norepinephrine. Epinephrine stimulates HR and Norepinephrine controls or maintains blood pressure
In pheochromocytoma, benign tumors are present which secretes epi and norepi in boluses. They tend to be familial so screen the family
Bp and HR are increased
Which leads to palpitations
Extremely diaphoretic
Yes. Headache will be experienced by these clients
Diagnosed by giving epi or norepi
Also diagnosed by checking cathecholamine levels using:
Vanillymandelic acid test
Metanephrine test
- this is screenes by 24 hour urine specimen, first void thrown away and keep last void
Anything with vanilla in it. Must not eat several days to a week Banana B vitamin Vanilla Caffeine Fruit juices
Treatment is SURGERY to remove tumors
Palpating abdomen in Pheochromocytoma
AVOID!! Because it might cause sudden release of cathecholamines which will lead to severe Hypertension
Adrenal cortex contains
“Glucocorticoids regulate CALBI”
Mineralocorticoids aka
Sex hormones( testosterone, estrogen and progesterone)
Too many sex hormones
Not enough sex hormones
Glucocorticoids, mineralocorticoids and sex hormones– STEROIDS
Change your mood: depressed,psychotic,euphoric
Altered defense Mechanism, high risk for infection
Breakdown of Fats and Proteins
Inhibits insulin, leading to hyperglycemic
Aldosterone. Retains NA and H2O. Make you lose K
Too many sex hormones:
Horsutism
Acne
Irregular menstrual cycle
Not enough sex hormones:
Decreased axillary or pubic hair
Decreased libido
ACTH ( adrenocorticotropin hormones ) mase in pituitary and stimulates
Increased ACTH =
Just another fancy word. Think
Cortisol to be made. Cortisol is a hormone in adrenal cortex. Helps reduce inlfammation
Increased cortisol
Steroids.
