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Care of Adult/Older Exam #3 (5701) > Hyper/Hypo Thyroidism > Flashcards

Hyper/Hypo Thyroidism Flashcards

1
Q

Hyperthyroidism

A
  • A sustained increase in synthesis and release of thyroid hormones by thyroid gland
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2
Q

Hyperthyroidism occurs more often in men or women?

A

women

-

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3
Q

Highest frequency in Hyperthyroidism is found in what age group?

A

20- to 40-year-olds

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4
Q

Common symptoms of Hyperthyroidism in a younger adult?

A

nervousness, irritability, weight loss, heat intolerance, warm/moist skin

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5
Q

Common symptoms of Hyperthyroidism in an older adult?

A

anorexia, weight loss, apathy, lassitude, depression, confusion

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6
Q

medical term for lack of energy?

A

Lassitude

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7
Q

Lassitude

A

medical term for lack of energy?

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8
Q

Cardiac symptoms of Hyperthyroidism in a younger adult?

A

tachycardia, palpitations, no HF

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9
Q

Cardiac symptoms of Hyperthyroidism in an older adult?

A
  • angina
  • dysrhythmia (esp. A-Fib RVr)
  • HF
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10
Q

Most common cause of Hyperthyroidism?

A

Graves’ disease-autoimmune

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11
Q

Causes of Hyperthyroidism?

A
  • Graves’ disease-autoimmune
  • Thyroiditis
  • Toxic nodular goiter
  • Exogenous iodine excess
  • Pituitary tumors
  • Thyroid cancer
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12
Q

Clinical syndrome of hypermetabolism resulting from increased circulating levels of T3, T4, or both

A

Thyrotoxicosis

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13
Q

Thyrotoxicosis

A

Physiologic effects/clinical syndrome of hypermetabolism resulting from increased circulating levels of T3, T4, or both
- heat intolerance
- weight loss
- palpitations
- weakness/fatigue

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14
Q

What two conditions occurring together is known as Grave’s disease?

A

Hyperthyroidism and Thyrotoxicosis

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15
Q

Causes of Grave’s disease?

A
  • Insufficient iodine supply
  • Infection
  • Stressful life events interacting with genetic factors
  • Cigarette smoking
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16
Q

General Signs and Symptoms Of Hyperthyroidism?

A
  • Weight loss-despite increased appetite
  • Nervousness-inability to concentrate
  • rapid pulse
  • heat intolerance
  • ↑ Sensitivity to stimulant drugs
  • Elevated basal temperature
  • Goiter
  • Ophthalmopathy
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17
Q

Protrusion of eyeballs from the orbits

A

Exophthalmos

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18
Q

Exophthalmos

A

Protrusion of eyeballs from the orbits

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19
Q

Cardiovascular System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Bruit over thyroid gland
  • Systolic hypertension
  • ↑ Cardiac output
  • Dysrhythmias
  • Cardiac hypertrophy
  • Atrial fibrillation
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20
Q

GI System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • ↑ Appetite, thirst
  • Weight loss
  • Diarrhea
  • Splenomegaly
  • Hepatomegaly
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21
Q

Integumentary System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Warm, smooth, moist skin
  • Thin, brittle nails
  • Hair loss
  • Clubbing of fingers
  • Diaphoresis
  • Vitiligo
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22
Q

Musculoskeletal System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Fatigue
  • Muscle weakness
  • Proximal muscle wasting
  • Dependent edema
  • Osteoporosis
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23
Q

Swelling and clubbing of the fingers associated with Grave’s disease?

A

Acropachy

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24
Q

Acropachy

A

Swelling and clubbing of the fingers associated with Grave’s disease

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25
Q

Nervous System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Fine tremors
  • Insomnia
  • Lability of mood, delirium
  • Hyperreflexia of tendon reflexes
  • Inability to concentrate
26
Q

Reproductive System Signs and Symptoms/Complications of Hyperthryoidism?

A
  • Menstrual irregularities
  • Amenorrhea
  • Decreased libido
  • Impotence
  • Gynecomastia in men
  • Decreased fertility
27
Q

Diagnostics for Hyperthyroidism?

A
  • Physical Assessment
  • Decreased TSH levels (<0.4mIU/L)
  • Elevated Thyroxine (free T4)
  • Radioactive iodine uptake test
    • Graves 35-95% uptake
    • Thyroiditis less than 2%
28
Q

Causes of Thyrotoxic crisis or Thyroid Storm?

A

infection, trauma, or surgery with preexisting hyperthyroidism

29
Q

S/S of Thyrotoxic crisis-thyroid storm?

A

tachycardia, HF, shock, hyperthermia (up to 106F), restlessness, n/v

30
Q

Treatmentof Thyrotoxic crisis-thyroid storm?

A

decrease thyroid hormone, control fever, fluid replacement, decrease/eliminate stressors

31
Q

Tx of Hyperthyroidism?

A 
Antithyroid drugs
Iodine
Radioactive Iodine Therapy
B-Adrenergic Blocker
Surgical therapy
Nutritional Therapy
32
Q

Antithyroid drugs-inhibit the synthesis of thyroid hormone

A

Methimazole

33
Q

Methimazole

A

Antithyroid drugs-inhibit the synthesis of thyroid hormone

34
Q

Why is Iodine given to pts as treatment for hyperthyroidism?

A

Inhibit synthesis of T3 and -T4, block release of hormones

35
Q

Inhibit synthesis of T3 and T4, block release of hormones

A

Iodine

36
Q

B-Adrenergic Blocker

A
  • Tx for thyrotoxicosis

- Blocks SNS, decrease tachycardia, nervousness, irritability, tremors

37
Q
  • Tx for thyrotoxicosis

- Blocks SNS, decrease tachycardia, nervousness, irritability, tremors

A

B-Adrenergic Blocker

38
Q

Nutritional Therapy for Hyperthyroidism?

A
  • High calorie diet (4-5K cal/day)
  • Six full meals
    • High proteins, carbs, minerals, and vitamin
  • Avoid caffeine
39
Q

Preferred surgical procedure for Hyperthyroidism?

A

Subtotal thyroidectomy

40
Q

Complications from surgical tx of Hyperthyroidism?

A
  • Damage or removal of the parathyroid gland may cause:
  • Hypoparathyroidism and hypocalcemia
  • Hemorrhage
  • Infection
  • Laryngeal nerve damage
  • Tracheal compression
41
Q

Harsh vibratory sounds heard with respirations following surgical tx of hyperthyroidism?

A

Laryngeal stridor

42
Q

Post-op Nursing Assessment/Interventions surgical tx of hyperthyroidism?

A
  • Vitals Q 2 hours
  • hemorrhage
  • tracheal compression
    • Frequent swallowing
    • Sensation of fullness
      at incision site
    • Blood on dressing
  • Semi-fowlers position-support neck, avoid hyper extension
  • assess for Laryngeal Stridor
  • Hypocalcemia for 72 hours
  • Treat pain
43
Q

Signs of a tracheal compression following surgical tx of hyperthyroidism?

A
  • Frequent swallowing
  • A sensation of fullness at the incision site
  • Blood on dressing
44
Q

Post-op Nursing Teaching for surgical tx of hyperthyroidism?

A
  • C&DB
  • Leg exercises
  • Support head manually while turning in bed
  • ROM neck exercises
  • Decrease caloric intake,
  • Decrease exercise
  • avoid high temps
  • life long thyroid replacement
45
Q

Discharge Teaching

Subtotal thyroidectomy?

A
  • Monitor for signs of hypothyroidism
  • Will not take a thyroid replacement
  • Need some iodine – normal use of iodized salt
  • Regular exercise
  • Avoid extreme environmental temperatures
  • Decrease calorie intake
  • Regular follow-up care
46
Q

Discharge Teaching Total thyroidectomy?

A
  • Will be on a lifelong thyroid replacement
  • Decrease calorie intake
  • Regular follow-up care
47
Q

most common cause

of Hypothyroidism world wide?

A

Iodine deficiency

48
Q

Causes of Hypothyroidism

A
  • Insufficient circulating thyroid hormone
  • Primary-destruction of thyroid tissue or defective hormone replacement
  • Secondary-pituitary disease
  • treatment of hyperthyroidism
  • Iodine deficiency
49
Q

Secondary Hypothyroidism is cause by?

A

pituitary disease

50
Q

risk factors of Hypothyroidism?

A

Female, white ethnicity, advancing age, type 1 diabetes, Down syndrome, family history, goiter, previous hyperthyroidism, previous radiation treatment

51
Q

S/S of Hypothyroidism

A
  • NO symptoms to classic symptoms
  • Fatigue, muscle weakness, and edema
  • Cold, dry skin
  • Hair loss
  • Constipation
  • Cold intolerance
  • Impaired memory and confusion
  • Weight gain
  • Lethargic, lacks initiative, Slow speech, personality changes
  • Brittle nails
  • Hoarseness
  • Menorrhagia
52
Q

Cardiovascular System Signs and Symptoms/Complications of Hypothyroidism?

A
  • ↓ Cardiac contractility and output
  • ↑ Serum cholesterol and triglycerides
  • Anemia
53
Q

Diagnostics of Hypothyroidism?

A
  • TSH
    • ↑if thyroid function is ↓
    • ↓ if problems with pituitary gland or hypothalmus
  • ↓ Thyroxine (free T4)
  • ↑ Cholesterol & triglycerides
  • ↓ RBCs
54
Q

Treatment of Hypothyroidism?

A
  • Levothyroxine (Synthroid)
  • REPORT HR > 100 bpm or CP IMMEDIATELY
  • Life long therapy – take in AM on empty stomach
55
Q

Levothyroxine (Synthroid) side effects?

A
  • weight loss
  • nervousness
  • tremors
  • insomnia
56
Q

Complications of Hypothyroidism?

A
  • Mental sluggishness, drowsiness and lethargy progress gradually or suddenly to impairment of consciousness or coma
  • Myxedema Coma
57
Q

s/s of Myxedema Coma

A
  • low temp
  • hypotension
  • hypoventilation
  • puffiness
  • periorbital edema
  • mask-like effect
58
Q

Treatment for Myxedema coma?

A
  • Monitor cardiac function
  • Monitor core body temperature
  • Mechanical respiration support
  • IV hormone replacement
59
Q

Patient presents with diagnosis of hypothyroidism, low temp, hypotension, hypoventilation. What condition is expected?

A

Myedema coma

60
Q

s/s of overdose of hypothyroidism treatment?

A
  • orthopnea,l
  • dyspnea
  • rapid pulse
  • palpitations,
  • nervousness
  • insomnia

Care of Adult/Older Exam #3 (5701) (8 decks)

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