Endocrine: Thyroidectomy, Hypothyroid, and Parathyroid Flashcards
What are the complications that can occur after a thyroidectomy? (5)
- hemorrhage
- thyroid storm
- Airway obstruction
- hypocalcemia
- laryngeal nerve damage
After a thyroidectomy, where should the nurse check for bleeding?
Back of neck
How much drainage will occur after thyroidectomy?
50 mL in first 24 hour, then scant
T or F: the client should avoud neck flexion after a thyroidectomy
True!
**always support the neck!
How can thyroid storm be avoided?
keep pt cool and keep pt on continuous cardiac monitoring
What would alert the nurse that the pt was having an airway obstruction/respiratory distress?
Sudden stridor and restlessness
What can help with edema after thyroidectomy?
- humidify air
- assist in coughing/breathing
- provide oral/tracheal suction
**keep tracheostomy supplies at bedside
HYPER or HYPO calcemia after thyroidectomy?
HYPO
What are signs of hypocalcemia?
- tingling of fingers and toes, spasms, confulsions
- Chvostek and Trousseau signs
What could laryngeal nerve damage cause?
vocal cord paralysis and vocal disturbances
What can be done to avoid laryngeal nerve damage after a Thyroidectomy?
- teach pt that they will be hoarse
- pt needs to REST VOICE
- monitor ability to speak every time you do VS (tone, quality, etc)
Labs for HYPOthyroidism:
Serum T3
Decreased
Labs for HYPOthyroidism:
Serum T4
Decreased
Labs for HYPOthyroidism:
TSH stimulation test for PRIMARY
No response or reduced
Labs for HYPOthyroidism:
TSH stimulation test for SECONDARY
Normal
Labs for HYPOthyroidism:
Thyrotropin receptor antibodies
No response
Labs for HYPOthyroidism:
TSH in PRIMARY
high
**low in secondary
Labs for HYPOthyroidism:
TSH in SECONDARY/TERTIARY
low
**high in primary
How is Hypothyroidism treated?
lifelong hormone treatment
What drug is used for hypothyroidism treatment?
Levothyroxine (synthroid)
Teaching for Levothyroxine?
- 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
T or F: Levothyroxine should be started high and then tapered?
F–start LOW then increase
What complication can occur due to hypothyroidism meds?
myxedema coma!!
**give IV NS, Levothyroxine IV, glucose, corticosteroids
HYPERparathyroidism labs:
Calcium
Increased
HYPERparathyroidism labs:
Phosphorous
Decreased
HYPERparathyroidism labs:
Magnesium
Increased
HYPERparathyroidism labs:
PTH
Increased
HYPERparathyroidism labs:
Vitamin D
Variable
HYPOparathyroidism labs:
Calcium
decreased
HYPOparathyroidism labs:
Phosphorous
Increased
HYPOparathyroidism labs:
Magnesium
Decreased
HYPOparathyroidism labs:
PTH
decreased
HYPOparathyroidism labs:
Vitamin D
decreased
What labs are DECREASED with DECREASED PTH
Calcium and Vitamin D
What labs are INCREASED with INCREASED PTH
Calcium
Magnesium
