Endocrine: Thyroidectomy, Hypothyroid, and Parathyroid

Question 1

What are the complications that can occur after a thyroidectomy? (5)

Answer 1

• hemorrhage
• thyroid storm
• Airway obstruction
• hypocalcemia
• laryngeal nerve damage

Question 2

After a thyroidectomy, where should the nurse check for bleeding?

Answer 2

Back of neck

Question 3

How much drainage will occur after thyroidectomy?

Answer 3

50 mL in first 24 hour, then scant

Question 4

T or F: the client should avoud neck flexion after a thyroidectomy

Answer 4

True!

**always support the neck!

Question 5

How can thyroid storm be avoided?

Answer 5

keep pt cool and keep pt on continuous cardiac monitoring

Question 6

What would alert the nurse that the pt was having an airway obstruction/respiratory distress?

Answer 6

Sudden stridor and restlessness

Question 7

What can help with edema after thyroidectomy?

Answer 7

• humidify air
• assist in coughing/breathing
• provide oral/tracheal suction

**keep tracheostomy supplies at bedside

Question 8

HYPER or HYPO calcemia after thyroidectomy?

Answer 8

HYPO

Question 9

What are signs of hypocalcemia?

Answer 9

• tingling of fingers and toes, spasms, confulsions

- Chvostek and Trousseau signs

Question 10

What could laryngeal nerve damage cause?

Answer 10

vocal cord paralysis and vocal disturbances

Question 11

What can be done to avoid laryngeal nerve damage after a Thyroidectomy?

Answer 11

• teach pt that they will be hoarse
• pt needs to REST VOICE
• monitor ability to speak every time you do VS (tone, quality, etc)

Question 12

Labs for HYPOthyroidism:

Serum T3

Answer 12

Decreased

Question 13

Labs for HYPOthyroidism:

Serum T4

Answer 13

Decreased

Question 14

Labs for HYPOthyroidism:

TSH stimulation test for PRIMARY

Answer 14

No response or reduced

Question 15

Labs for HYPOthyroidism:

TSH stimulation test for SECONDARY

Answer 15

Normal

Question 16

Labs for HYPOthyroidism:

Thyrotropin receptor antibodies

Answer 16

No response

Question 17

Labs for HYPOthyroidism:

TSH in PRIMARY

Answer 17

high

**low in secondary

Question 18

Labs for HYPOthyroidism:

TSH in SECONDARY/TERTIARY

Answer 18

low

**high in primary

Question 19

How is Hypothyroidism treated?

Answer 19

lifelong hormone treatment

Question 20

What drug is used for hypothyroidism treatment?

Answer 20

Levothyroxine (synthroid)

Question 21

Teaching for Levothyroxine?

Answer 21

• take meds SAME TIME every day 30 min before brekfast
• check BP and HR daily
• include fiber/water in diet
• no OTC meds unless approved
• not hours of sleep/night

Question 22

T or F: Levothyroxine should be started high and then tapered?

Answer 22

F–start LOW then increase

Question 23

What complication can occur due to hypothyroidism meds?

Answer 23

myxedema coma!!

**give IV NS, Levothyroxine IV, glucose, corticosteroids

Question 24

HYPERparathyroidism labs:

Calcium

Answer 24

Increased

Question 25

HYPERparathyroidism labs:

Phosphorous

Answer 25

Decreased

Question 26

HYPERparathyroidism labs:

Magnesium

Answer 26

Increased

Question 27

HYPERparathyroidism labs:

PTH

Answer 27

Increased

Question 28

HYPERparathyroidism labs:

Vitamin D

Answer 28

Variable

Question 29

HYPOparathyroidism labs:

Calcium

Answer 29

decreased

Question 30

HYPOparathyroidism labs:

Phosphorous

Answer 30

Increased

Question 31

HYPOparathyroidism labs:

Magnesium

Answer 31

Decreased

Question 32

HYPOparathyroidism labs:

PTH

Answer 32

decreased

Question 33

HYPOparathyroidism labs:

Vitamin D

Answer 33

decreased

Question 34

What labs are DECREASED with DECREASED PTH

Answer 34

Calcium and Vitamin D

Question 35

What labs are INCREASED with INCREASED PTH

Answer 35

Calcium

Magnesium