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NCLEX - HURST REVIEW (Endocrine) > Endocrine - Hyperthyroidism (Too much Energy/Grave's Disease) > Flashcards

Endocrine - Hyperthyroidism (Too much Energy/Grave's Disease) Flashcards

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1
Q

The Thyroid gland produces what 3 hormones?

A

T3, T4, Calcitonin

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2
Q

_____________ decreases serum calcium levels by taking calcium out of the blood and pushing it back into the bone ?

A

Calcitonin

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3
Q

What do you need to make hormones ?

A

Iodine

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4
Q

Thyroid hormones give us _________ ?

A

Energy !

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5
Q

A Hyperthyroid is also known as what ?

A

Graves Disease (Too much energy!)

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6
Q

Signs & Symptoms of Hyperthyroidism (Graves Disease) ?

A
  • Nervous
  • Irritable
  • Decreased attention span
  • Increased appetite
  • Decreased weight
  • Sweaty/hot (b/c of increased energy and sweat production)
  • Exophthalmos (bulging eyes)
  • Fast GI
  • Increased BP and HR
  • Arrhythmias/palpitations
  • Thyroid size increases
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7
Q

Eye care for Grave’s eye disease ?

A
  • Sunglasses
  • apply cool compress for moisture
  • lubricating eye drops
  • Elevate HOB to reduce swelling
  • Steroids and/or surgery may be needed
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8
Q

Diagnosing Hyperthyroidism (Graves Disease)

  • Would a T4 (thyroxine) level be increased or decreased ?
A

Increased

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9
Q

Diagnosing Hyperthyroidism (Graves Disease)

Would TSH be increased or decreased ?

A

Decreased

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10
Q

Are Thyroid scans used to diagnosis Hyperthyroidism (Graves Disease) ?

A

Yes

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11
Q

How far in advance should Iodine containing medications be discontinued prior to a thyroid scan ?

A

1 week prior

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12
Q

How long after a thyroid scan (Hyperthyroidism) must a pt. wait to restart medications (iodine containing?)

A

6 weeks

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13
Q

What are treatments for Hyperthyroidism (Grave’s Disease) ?

A
  • Anti-thyroids
  • Iodine compounds
  • Beta Blockers (supportive therapy)
  • Radioactive iodine therapy
  • Surgery
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14
Q

What are 2 Anti-thyroid medications used for Hyperthyroidism (Grave’s Disease) ?

A
  • Methimazole (Tapazole)

- Propylthiouracil (PTU)

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15
Q

Which of the 2 anti-thyroid medication is the favorite and why ?

A

Methimazole

  • Because its a single dose with less side effects :)
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16
Q

What do Anti-thyroid medications do ?

A

Stop the thyroid from making thyroid hormones

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17
Q

For a patient with Hyperthyroidism (Grave’s Disease), why are we giving Anti-thyroid medications ?

A

We want the patient to become euthyroid

eu = Normal

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18
Q

ALL endocrine glands are very what ?

A

VERY VASCULAR !

19
Q

Why are Iodine Compounds given for Hyperthyroidism (Grave’s Disease) ?

A

Decrease the size and vascularity of the gland

20
Q

What is an example of an Iodine Compound?

A

Potassium Iodine

21
Q

How should Iodine compounds be given ? Why ?

A
  • Given in milk or juice & use a straw

- To prevent staining the teeth

22
Q

Why are Beta Blockers (-lol) used as treatment modality for Hyperthyroidism (Grave’s Disease) ?

A

Supportive Therapy

23
Q

What Beta Blocker is used in the treatment of Hyperthyroidism (Grave’s Disease) ?

A

Propranolol (Inderal)

24
Q

What effects do Beta Blockers have in the treatment for Hyperthyroidism ?

A
  • Decrease myocardial contractility
  • Could decrease CO
  • Decrease HR and BP (increased BP and HR = s/s)
  • Decrease anxiety (increased anxiety =s/s)
25
Q

How does Radioactive Iodine therapy work for the treatment of Hyperthyroidism ?

A

Destroys Thyroid Cells (–> Hypothyroidism)

26
Q

What is the dosage Given for Radioactive Iodine Therapy ? Route ?

A
  • 1 dose

- Given PO (liquid or tablet form)

27
Q

Radioactive precautions for radioactive iodine therapy state that individuals should…

  • Stay away from babies for how long ?
  • Dont kiss anyone for how long ?
A
  • Stay away from babies for 1 week

- Dont kiss anyone for 1 week

28
Q

TESTING STRATEGY

You should not give Beta Blockers to ________ or _________ ?

A

Asthmatics or diabetics

29
Q

What do you want to watch for in a person with Hyperthyroidism (Grave’s Disease) receiving Radioactive iodine ?

A

Thyroid storm (thyrotoxicosis or thyrotoxic crisis)

Could be a rebound effect post-radioactive iodine

30
Q

What is a thyroid strom ?

A

Hyperthyroidism multiplied by 100

31
Q

What are 2 other names for a thyroid storm ?

A
  • Thyrotoxicosis

- Thyrotoxic crisis

32
Q

What is a last resort (?) treatment modality for Hyperthyroidism (Grave’s Disease ?

A

Surgery (Thyroidectomy –> Partial/complete)

33
Q

When does surgery become an option in a pt with Hyperthyroidism (Grave’s Disease) ?

A

Done when a client has a

  • large goiter
  • thyroid cancer
  • did not respond to anti-thyroid therapy
34
Q

What is the post-op priority for a patient who underwent a thyroidectomy ?

      - A pt might report feelings of what ?
A
  • Hemorrhage

- Might report feeling of pressure

35
Q

In a patient who just underwent a Thyroidectomy for Hyperthyroidism ( Grave’s Disease), Where would you check for bleeding ?

A

At the incision site and behind the neck

36
Q

What must you assess for in a patient who underwent a thyroidectomy ?

A

Assess for recurrent laryngeal nerve damage by listening for hoarseness and weak voice

37
Q

Could recurrent laryngeal nerve damage lead to vocal cord paralysis ?

A

Yes

38
Q

When there is paralysis of both cords following a thyroidectomy, __________ obstruction will occur ? requiring an immediate _______ ?

A

Airway obstruction

Trach

39
Q

Following a Thyroidectomy for Hyperthyroidism (GRave’s Disease), what should be at the bed side ?

A

Trach set

40
Q

Why should a trash set be at the bedside for a post-thyroidectomy patient ?

A
  • Swelling
  • Recurrent laryngeal nerve damage (vocal cord paralysis)
  • Hypocalcemia
41
Q

Post- Thyroidectomy, what should you teach the patient ?

A

How to support the neck

42
Q

How should you position the HOB for a post-thyroidectomy patient ? and why ?

A
  • HOB should be increased

- Why –> to decrease edema

43
Q

What nutrition needs does a thyroidectomy patient require pre & post- op ?

A

Increased calories

NCLEX - HURST REVIEW (Endocrine) (10 decks)

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