HYPERTHYROIDISM

Question 1

Hyperthyroidism is also called?

Answer 1

Thyrotoxicosis

Question 2

basic concept of hyperthyroidism

Answer 2

” Everything is high and wet”

Question 3

Incidence in hyperthyroidism

Answer 3

Female

Question 4

What are the 3 basic concepts in hyperthyroidism

Answer 4

HII

HYPOCALCEMIA
INCREASED METABOLIC RATE
INCREASED BODY HEAT PRODUCTION

Question 5

Most common cause of hyperthyroidism

Answer 5

Grave’s disease

Question 6

Factors that can cause hyperthyroidism

Answer 6

ANE

Autoimmune
Neoplasm
Excessive intake of thyroid

Question 7

Due to increased metabolism the patient may experience

Answer 7

Increased appetite
Weight loss
Heat intolerance

Question 8

Due to activation of CNS and SNS the patient might experience

Answer 8

HDP

Hypertension
Diaphroesis
Palpitation

Question 9

Due to hypocalcemia the patient might experience

Answer 9

GRINDH

GI motility
Restlessness
Increased neuromuscular irritability
Nervousness
Diarrhea
Hyper active bowel sounds

Question 10

The protrusion of one or both eyes

Answer 10

Exophthalmos

Question 11

Describes an abnormal vertical wideness of the palpebral fissure

Answer 11

Von Graefe’s

Question 12

The forehead remains smooth when one looks up/ lack of wrinkling of the forehead when a patient looks up with the head bent forwards

Answer 12

Jeffrey’s

Question 13

Forward displacement of the eye ; the bulging of one or both or your eyes from their natural position

Answer 13

Proptosis

Question 14

Signs and symptoms of proptosis

Answer 14

BLEPD

Bloody vision
Lacrimation
Eye pain
Photophobia
Diplopia

Question 15

2 types of iodides

Answer 15

Lugol’s solution
SSKI - Saturated solution of potassium iodide

Question 16

It is a administered before performing thyroidectomy to avoid bleeding

Answer 16

Lugol’s solution

Question 17

Nursing responsibilities in using iodides

Answer 17

Assess for hypersensitivity to iodine before giving medication

Dilute liquid iodine to cold water / fruit juices to mask the bitter taste

Monitor for increased bleeding if the client is also taking anticoagulants

Question 18

What are the common side effects of iodine

Answer 18

AMIC VARS

Allergic reaction
Metallic or brassy taste
Increased salivation
Coryza
Vomiting
Abdominal pain
Rashes
Sore gums

Question 19

2 types of thioamides

Answer 19

Methymazole
Prophylthiouracil

Question 20

Mechanism of action of thioamides

Answer 20

Inhibit TH production

Question 21

Methimazole/Tapazole can be taken
in _____ daily dose

Answer 21

1

Question 22

Propylthiouracil must be taken in ______ doses daily

Answer 22

3

Question 23

Methimazole/Tapazole is contraindicated in

Answer 23

Pregnant patient

Question 24

What are the side effects of THIOAMIDES

Answer 24

ARFSSD

Agranulocytosis/neutropenia with leukopenia
Rashes
Fever
Sore throat
Sore gums
Diarrhea

Question 25

Other side effects of THIOAMIDES

Answer 25

HPPALM Hypothyroidism Pruritus Periorbital edema Anorexia Lose of taste Menstrual changes

Question 26

What to consider in administering THIOAMIDES

Answer 26

Administer at same time each day with meals

Question 27

Full effects of antithyroid hormones experienced in ____ weeks

Answer 27

12

Question 28

Take medication regularly and exactly. Do not discontinue abruptly to prevent ________

Answer 28

Thyroid storm

Question 29

What are the over-all nursing responsibilities when taking antithyroid medications

Answer 29

MAAAW Monitor BP and PR and weight Administer with meals to prevent GI bleeding Avoid ASA and iodine- containing medications Advise client to consult physician before eating iodized salt and iodine- rich foods Weight gain

Question 30

Beta blocker that control HTN and tachycardia

Answer 30

Inderal / propanolol

Question 31

It inhibits the action of thyroid hormones

Answer 31

Calcium - channel blockers, dexamethasone /glucocorticoids

Question 32

2 types of thyroïdectomy

Answer 32

Sub-total thyroidectomy Total thyroidectomy

Question 33

5/6 of the gland is removed, leaves enough of the gland in place to produce an adequate amount of TH

Answer 33

Sub-total thyroïdectomy

Question 34

This surgery treats cancer of the thyroid and the client requires lifelong hormone replacement

Answer 34

Total thyroidectomy

Question 35

Before surgery, the client should be in as nearly __________ as possible

Answer 35

Euthyroid state

Question 36

What will you assess during perioperative care in patients that will undergo thyroïdectomy

Answer 36

Vital sign Weight Electrolyte levels Hyperglycemia Glycosuria

Question 37

In perioperative care why should you teach client to support the neck when sitting up in bed, while moving about and while

Answer 37

To prevent hyper extension of the neck

Question 38

In perioperative care teach the client to expect hoarseness of voice because of

Answer 38

Laryngeal nerve damage

Question 39

If the patient experiences mild hoarseness of voice it is due to ________

Answer 39

Intubation

Question 40

What will you do if the patient experiences severe hoarseness of voice

Answer 40

Notify HCP due to possible inadvertent of parathyroid gland that can lead to respiratory arrest

Question 41

In perioperative care, why should you place an ECG______

Answer 41

Prove to cardiac arrest

Question 42

Medications that prevent thyroid storm

Answer 42

Lugol's solution Propanolol Dexamethasone

Question 43

It reduce vascularity of the thyroid gland

Answer 43

Lugol's solution

Question 44

It inhibits in action of thyroid hormone

Answer 44

Dexamethasone

Question 45

In postoperative care for thyroïdectomy, in giving comfort measures administer ___________ for pair

Answer 45

Analgesics

Question 46

In postoperative care position the patient in __________________(with head, neck and shoulders erect) after recovery and support head and neck with pillows

Answer 46

Semi - fowlers

Question 47

If hemorrhage occurs where will you assess the patient?

Answer 47

Under/back of the neck and shoulders

Question 48

what will you do in postoperative care if respiratory distress occurs

Answer 48

Assess RR, rhythm, depth and effort Assist with deep breathing and coughing exercises

Question 49

During postoperative care if respiratory distress occur you must have ____________________, oxygen and a tracheostomy set available for immediate use

Answer 49

Suction equipment

Question 50

If laryngeal nerve damage occur assess for ability to speak aloud every _________, noting quality and tone of voice

Answer 50

Hour

Question 51

If laryngeal nerve damage occur limit talking and _______________

Answer 51

assess for level of hoarseness

Question 52

Signs of laryngeal nerve damage

Answer 52

Restlessness Respiratory obstruction High pitch voice Stridor Dysphagia

Question 53

What is tetany?

Answer 53

Involuntary contraction of muscles due to hypocalcemia

Question 54

Signs and symptoms of tetany

Answer 54

Parasthesia Muscle twitching Convulsion Seizures + chovstek's sign + trosseau's sign

Question 55

Drug of choice of tetany

Answer 55

Calcium gluconate / calcium chloride

Question 56

Tetany occurs in ________days after surgery

Answer 56

1-7

Question 57

What happens during thyroid storm?

Answer 57

Thyroid hormones enters the blood stream