HYPER AND HYPOTHYROIDISM Flashcards
Also called Thyrotoxicosis
Hyperthyroidism
Incidence in Hyperthyroidism
Female <40 yrs. old
Hyper: Diet
High Calorie and Low Fiber
The cause of Grave’s Disease is __ but there is a ___.
Unknown; Hereditary link
Hyper: FACTORS
Autoimmunity
Neoplasms
Excessive intake of Thyroid meds
Most common cause of Hyper?
Grave’s Disease
Hypocalcemia results to?
Increased membrane permeability which leads to Increased neuromuscular irritability
Hyper: Manifestations
Everything is HIGH and WET
Due to Increased metabolism
High appetite
Weight Loss
Heat intolerance
Due to Hypocalcemia
Hyperactive Bowel sounds
Diarrhea
Nervousness
Restlessness
Due to activation of CNS/ SNS
Hypertension
Diaphoresis
Palpitation
Hyper: Eye Manifestations
Exophthalmos
Von Graefe’s
Joffroy’s Sign
Proptosis
Protrusion of one or both eyes
Exophthalmos
the palpebral fissure in Von Graefe’s are?
Long and Deep
Abnormal vertical wideness of the Palpebral fissure.
Von Graefe’s
Cause of Exophthalmos?
Accumulation of Fluid at the Fat pads behind the eyeballs.
Joffroy’s Sign
Forehead remain smooth when looking up.
Iodides (2)
Lugol’s Solution
Saturated Solution of Potassium Iodide (SSKI)
Signs of Proptosis
Blurred Vision
Diplopia
Eye pain
Lacrimation
Photophobia
SSKI is also used in ___.
Thyroid Storm
Proptosis
Forward Displacement of the eye or Bulging
Give before Subtotal Thyroidectomy for less vascular
Lugol’s Solution
COMMON side effects of IODIDES
clue: VAMIC ARS
Vomiting
Allergic reaction
Metallic or Brassy taste
Increased Salivation
Coryza
Abdominal Pain
Rashes
Sore gums
Anti- thyroid meds: THIOAMIDES
Methimazole (Tapazole)
Prophythiouracil (PTU)
DOC of thyroid storm
Lugol’s Solution
Iodides that Inhibit TH synthesis and release
SSKI
Nursing Responsibilities in IODIDES: (5)
Assess for HYPERSENSITIVITY to Iodine.
Dilutes Iodine Sources: COLD WATER and FRUIT JUICES
Provide DRINKING STRAW.
Monitor for increased BLEEDING TENDENCIES.
Methimazole: Cannot be taken during?
Pregnancy
THIOAMIDES: Administer?
at the same time each day with meals.
Other SE of THIOAMIDES
Hypothyroidism
Pruritus
Periorbital Edema
Anorexia
Loss of Taste and Smell
Menstrual Changes
Full effects experienced in?
12 weeks
Methimazole: Can be taken in?
1 daily dose
Avoid ASA and Iodine containing meds.
Because it elevates Free Thyroid Hormone levels
PTU: Inhibit?
TH production
PTU: Must be taken in?
3 doses daily
THIOAMIDES: SE- Agranulocytosis/Neutropenia with leukopenia
FRD S/S
Other Meds for Hyperthyroidism? (2)
Beta Blocker and CCB
Weight Gain indicates?
Effectiveness of the meds
CCB - Glucocorticoids
Dexamethasone
5/6 of the Gland is removed
Subtotal Thyroidectomy
Periop Care: ASSESS
clue: GV WEH
Glucosuria
Vital Signs
Weight
Electrolyte levels
Hyperglycemia
Other Periop care for Subtotal Thyroidectomy
Teacg
Treats cancer of the thyroid and requires lifelong hormone replacement
Total Thyroidectomy
