Endocrine System Flashcards
thyroid and parathyroid
thyroid gland produce 2hormones
1)thyroxine (T3,T4)- increase metabolism and 2)calcitonin lower -serum calcium
thyroid assessment
1)ultrasonography:? Fluid filled nodules-or solid tumor?
2)thyroid scan:: for nodules. Radioactive isotopes are given orally Or I/V.
benign nodules appear as warm spots because they take up radionuclide.
Malignant tumors appear as clod sports because they tend not to take up radionuclide.
3)Radio active iodine uptake (RAIU)
1) Direct measure of thyroid activity.2) Radio active iodine given either orally or I/V.
3) The uptake by the thyroid gland is measured in intervals such as 2to4 hours and at 24 hours.
4) Instruct the patient to drink increased the amount of fluids for 24 to 48 hours unless this is contraindicated. Radionuclide will be eliminated in 6 to 24 hours.
Hypothyroidism symptoms
Metabolism -decreased in hypothyroidism
Weight gain,
intolerance cold( decreased sweating)
GI-Constipation /not hungry
CVS- low cardiac output/ low heart rate
respiratory (Respiration)– hypoventilation
muscle tone/reflex-decreased complication-myxedema
skin - dry hair loss, mood changes, and amenorrhea
Hyperthyroidism symptoms
increased metabolism
weight loss,
intolerance heat, increased sweating,
GA-Diarrhea/increased appetite
CVS - ,increased heart rate ,co/palpitation
Respirations - tachypnea/Dyspnea
Muscle tone/Reflex -increased
Complication- Exopthalamus,/Graves’ disease/thyroid storm/thyroid crisis
skin -increased perspiration/ moisture sweating
Myxedema myxedema: life-threatening crisis
Edema throughout body, severe metabolic disorders (hyperglycemia), CV Collapse,coma.
Major: airway patency, ECG, vital signs, and ABG.
? Hypoxia,? Hypothermia
Med: levothyroxine I/V bonus, corticosteroids
nursing: I/O, daily weight, vital signs
Any Trigger?(no meds?infection?)
levothyroxine
Adjust dose – blood test.
High-level of TSH-start/increase levothyroxine. Dose- once daily-an empty stomach.
Usually- lifelong therapy,can take up to 8weeks to see the full affect.
Exophthalmus
Increases orbital tissue expansion-can be irreversible.
Cornea: risk for dryness, injury, and infection.
Maintain the head of the bed in raised position-fluid drainage.
Use artificial tears-prevent corneal drying
tape the eye lidsshut during sleep if they do not close on their own,
teach:regular ophthalmologist visit.
exophthalmus for meds and education
anti- thyroid drug:Ex:propylothiouracil,Methimazole.
Smoking cessation -smoking increase exophthalmus.
Restrict salt intake to decrease periorbital edema.
Used dark glasses-decrease the glare, prevent external irritants and infection.
Perform intraocular muscle exercise (turning the eyes using complete range of motion)to maintain flexibility.
Thyroid crisis/Storm 
From a sudden surge of large amounts of thyroid hormones into the blood. Greater increase in the body metabolism-medical emergency
Thyroid crisis precipitating (risk)Factors 
Infection, trauma, emotional stress, diabetic keto acidosis, and digitalis toxicity( Digoxin under control).
It also can occur following a surgical procedure or a thyroidectomy as a result of manipulation of the gland during surgery.
Finding are hyperthermia, hypertension, hyperglycemia, dysrhythmias, chest pain, palpitations delirium, vomiting, abdominal pain, and Dyspnea
Thyroid storm – nursing care 
Maintain a patent airway.Start oxygen, continuous cardiac monitoring.
Hyper thermia management –-medicine, cool sponge, cooling blanket, avoid aspirin (salsalate increases salicylates thyroid hormone availability)
Administrate meds:anti-thyroid drugs – Thionamides
Propranolol to block sympathetic nervous system effects( tachycardia, palpitations).
glucocorticoids to treat shock. IV fluids to provide adequate hydration, insulin.
Thyroidectomy
Airway swelling is a life-threatening complication of thyroid surgery.
Signs of respiratory distress such as stridor and dyspnea requires rapid interventions.
have tracheostomies set,oxygen, suctioning at bedside at all times.
Position client in semi-Fowler’s position, Assess neck dressing for a bleeding(look behind neck). Monitor for a hypocalcemia crisis,access for signs of potential tetany.
Monitor for laryngeal nerve damage(some cannot talk, permanent voice changes, hoarseness, voice box effects, vocal cord damage or compress).
Diet with hyperthyroidism
Hyperthyroidism leads to high metabolic rate:
diet high in calories (high in protein, carbohydrates, vitamins and minerals)to satisfy hunger and prevent weight loss and tissue wasting.
Avoidance of high fiber – foods due to the constant hyperstimulation of the Gastrointestinal tract. However,high-fiber diets are recommended if the client with hyperthyroidism has constipation.
Avoidance of stimulating substances (example caffeinated drinks: coffee tea soft drinks).
avoidance of spicy foods as these can also increase GI stimulation.
Disorder parathyroid gland
Hyperparathyroidism: hyper resection of parathyroid hormones leads to increased calcium reabsorption and increased phosphate excretion.
Assess for hypercalcemia - bones,stones,groans, and moans.
Psychic moans Fatigue, depression, weakness.
Elevated levels In PTH will accelerate osteoporosis as calcium released from storage.
Calcium has-a diuretic affect, producing symptoms of polyuria and polydipsia.
High calcium levels can cause constipation (abdominal groans).
Access for hypophosphatemia-(muscles dysfunction, weakness, and mental status changes). Parathyroidectomy –care as thyroidectomy
hypoparathyroidism
hypo secretion of parathyroid hormones.
Access for hypocalcemia -cats (convulsion, arrhythmia,tetany, spasm or Studior).
Positive Trousseaus sign, positive Chvostek sign.
Have tracheostomy set, oxygen, suctioning at bedside at all time.
Prepared to administer calcium gluconate as prescribed for hypocalcemia
initiate seizure precautions.Client should have high calcium,low phosphorus diet.
