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MS Endocrine > HYPERTHYROIDISM > Flashcards

HYPERTHYROIDISM Flashcards

1
Q

Hypersecretion of thyroid hormones

A

Hyperthyroidism

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2
Q

Hyperthyroidism is also called

A

Thyrotoxicosis

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3
Q

Incidence of hyperthyroidism

A

Female (<40)

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4
Q

Most common cause of hyperthyroidism

A

Grave’s disease

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5
Q

It enhances the action of epinephrine and norepinephrine, increasing sympathetic activity and central nervous system

A

Thyroid hormones

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6
Q

Results to increased membrane permeability which leads to increased neuromuscular irritability

A

Hypocalcemia

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7
Q

Factors of Grave’s Disease (ANE)

A

Autoimmunity
Neoplasms
Excessive Intake of Thyroid Meds

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8
Q

Basic Concepts (MBH)

A

a. Increased Metabolic Rate (⬆️T3)
b. Increased Body heat production (heat intolerance)
c. Hypocalcemia (⬆️Thyrocalcitonin)

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9
Q

Manifestations (due to increased metabolism - WIH)

A

a. Weight Loss
b. Increased Appetite
c. Heat intolerance

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10
Q

Manifestations (due to activation of CNS and SNS - DiPaH)

A

a. Diaphoresis
b. Palpitation
c. Hypertension

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11
Q

Manifestation (due to hypocalcemia - HyNDiR)

A

a. Hyperactive bowel sounds
b. Nervousness
c. Diarrhea
d. Restlessness

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12
Q

Protrusion of one or both eye

A

Exophthalmos

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13
Q

Abnormal vertical wideness of the palpebral fissure

A

Von Graefe’s

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14
Q

Forehead remains smooth when one looks up

A

Joffroy’s

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15
Q

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

A

Proptosis

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16
Q

Signs of Proptosis (BLEPD)

A

a. Blurred Vision
b. Lacrimation
c. Eye pain
d. Photophobia
e. Diplopia

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17
Q

Inhibits thyroid hormone synthesis and release

A

Iodides

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18
Q

Given before subtotal thyroidectomy; DOC for thyroid storm

A

Lugol’s solution

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19
Q

Rationale for giving Lugol’s solution before subtotal thyroidectomy

A

Makes hyperplastic thyroid less vascular

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20
Q

Give 2 example of iodides

A

a. Lugol’s Solution
b. Saturated Solution Potassium Iodide (SSKI)

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21
Q

Nursing Responsibilities for giving Iodide (MADiP)

A

a. Monitor for increased bleeding tendencies if taking anticoagulants
b. Assess for hypersensitivity to iodine
c. Dilute iodine sources: cold water, fruit juice
d. Provide drinking straw: causes permanent teeth stain

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22
Q

Common side effects (iodism) - MARIVACS

A

a. Metallic or Brassy Taste Mouth
b. Allergic Reaction
c. Rashes
d. Increased Salivation
e. Vomiting
f. Abdominal Pain
g. Coryza
h. Sore Gums

23
Q

Inhibit Thyroid Hormone production

A

Thioamides

24
Q

______Can be taken in ______ dose

A

Methimazole - 1 daily

25
Q

Methimazole can be taken during pregnancy. T/F

A

F (contraindicated to pregnancy)

26
Q

______ Must be taken in _____ doses

A

Prophythiouracil - 3 daily

27
Q

Thioamides - Monitor for side effects (agranulocytosis/neutropenia with leukopenia) - DiFeRSS

A

a. Diarrhea
b. Fever
c. Rashes
d. Sore Throat
e. Sore Gums

28
Q

Thioamides - other side effects (PruPeHALM)

A

a. Pruritus
b. Periorbital Edema
c. Hypothyroidism
d. Anorexia
e. Loss of taste
f. Menstrual changes

29
Q

When should you administer thioamides? Rationale?

A

Administer at same time each day with meals to prevent thyroid storm

30
Q

If taking warfarin with thioamides: WOF?

A

Bleeding

31
Q

If taking lithium with thioamides: WOF?

A

Hypothyroidism

32
Q

How long does it take for the full effect of thioamides to happen?

A

12 weeks

33
Q

Overall nursing responsibilities when taking antithyroid medications - MWAdAv

A

a. Monitor BP, PR, and Weight
b. Weight gain indicates effectiveness of meds
c. Administer with meals to prevent GI irritation
d. Avoid ASA and iodine containing medications to elevate free thyroid hormone levels

34
Q

Function of beta blocker

A

To control hypertension and tachycardia

35
Q

Function of glucocorticoids

A

It inhibits the action of thyroid hormones

36
Q

5/6 of the gland is removed

A

Subtotal thyroidectomy

37
Q

Rationale for subtotal thyroidectomy

A

Leaves enough of the gland in place to produce adequate amount of thyroid hormone

38
Q

Treats cancer of the thyroid and the client requires lifelong hormone replacement

A

Total thyroidectomy

39
Q

Before surgery, client should be in as nearly euthyroid state as possible, assess (ViEWHG)

A

a. Vital Sign
b. Electrolyte Levels
c. Weight
d. Hyperglycemia
e. Glucosuria

40
Q

Perioperative Care (Thyroidectomy) - TTPA

A

a. Teach client to support neck when sitting up in bed, while moving about and while performing deep breathing and coughing techniques
b. Teach to expect hoarseness: mild
c. Place on ECG
d. Administer meds as prescribed to prevent thyroid storm: Lugol’s solution, Propanolol, glucocorticoids

41
Q

Postoperative Care (PP)

A

a. Provide comfort measures. Administer Analgesic pain meds
b. Position in semi-fowlers after recover and support head and neck with pillows

42
Q

Postoperative Care - Hemorrhage (AMA)

A

a. Assess dressing if present and the area under/back of the neck and shoulders
b. Monitor BP and pulse
c. Assess tightness of dressing if present

43
Q

Postoperative Care - Respiratory Distress (AHA)

A

a. Assess RR, rhythm, depth, and effort
b. Have suction equipment, oxygen, and a tracheostomy set available for immediate use
c. Assist with Deep Breathing and Coughing Exercise

44
Q

Postoperative Care - Laryngeal Nerve Damage (LAMS)

A

a. Limit talking and assess for level of hoarseness
b. Assess for ability to speak aloud every hour, noting quality and tone of voice
c. Mild hoarseness is normal
d. Severe hoarseness indicates laryngeal nerve damage and notify physician

45
Q

Observe for other signs of recurrent laryngeal nerve damage (SHiRRD)

A

a. Stridor
b. High pitched voice
c. Respiratory obstruction
d. Restlessness
e. Dysphagia

46
Q

Due to calcium deficiency

A

Tetany

47
Q

When does tetany occurs?

A

1-7 days after surgery

48
Q

DOC for tetany

A

Calcium gluconate

49
Q

S/s of tetany (3PsMC)

A

a. Paresthesia
b. Positive Chvostek’s sign
c. Positive Trousseaus
d. Muscle Twitching
e. Convulsion, Seizure

50
Q

Extreme state of hyperthyroidism

A

Thyroid Storm

51
Q

Thyroid Storm Factors

A

a. People with untreated hyperthyroidism
b. People with hyperthyroidism that have experienced infection, trauma, untreated DKA

52
Q

Thyroid Storm Manifestations

A

a. High fever/ hyperthermia
b. Tachycardia
c. Dysrhythmia
d. Hypertension
e. Nausea and vomiting
f. Diarrhea
g. Restlessness
h. Confusion
i. Agitation
j. Irritability
k. Tremors/seizures
l. Delirium and coma

53
Q

Collaborative Management (Thyroid Storm) - MAMIMU

A

a. Maintain patent airway and adequate ventilation
b. Administer antithyroid medication as prescribed
c. Monitor VS, I and O, neurologic status, cardiovascular status every 1 hour
d. Implement measures to lower fever
e. Maintain quiet, calm, cool, private environment until crisis is over
f. Use cooling blanket

54
Q

Patient teaching after thyroidectomy (SMHS)

A

a. Support neck with interlaced fingers when getting up from bed to prevent hyperextension of neck
b. Massage incision with cocoa butter lotion once healing occurs to minimize scarring
c. Have regular follow-up care
d. Start ROM exercises of the neck 3-4 days after discharge

MS Endocrine (2 decks)

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