Hyperthyroidism

Question 1

what is hyperthyroidism?

Answer 1

Hyperthyroidism happens when the thyroid gland makes too much thyroid hormone. This condition also is called overactive thyroid. Hyperthyroidism speeds up the body’s metabolism.

Question 2

what are the S/S of hyperthyroidism?

Answer 2

• High BP, HR
• Heat intolerance
• Weight loss, Muscle wasting
• Exophthalmos
• Straight Hair
• Thin Brittle nails
• Diarrhea/Hyperactive bowel sounds
• Nervous, irritability, tremors

Question 3

What are the common meds for Hyperthyroidism?

Answer 3

Note that women must get a pregnancy test prior starting any therapy.

• Anti-thyroid drugs: Methimazole and Propylthiouracil (PTU)
• Iodine: give iodine and antithyroid drugs to prepare for thyroidectomy or thyrotoxicosis.
  B-adrenergic blockers: *Propranolol (safe for pregnant women), Atenolol, Metoprolol
• Radiation therapy: Radioactive Iodine is not for pregnant women.

With radiation therapy, educate patient for potential of dry mouth and throat irritation. We instruct them to take a small sips of water and ice chips. Gargle 1 tsp pf salt and 1 tsp of baking soda in 2 cups of water 3-4 times a day.

Precaution: : use separate toilet, wash cloths separating, limit out of time when cooking for other people, tell them they have to stay away from children and preg people for 7 days after treatment stop

Question 4

what patient education should be taught in hyperthyroidism?

Answer 4

• Teach symptoms of hypothyroidism to patients post op
• High calorie diet:
• EAT: 6 full meals a day and snacks high in protein (1-2g/kg of ideal body weight),
  carbohydrates, minerals, & vitamins
• Avoid high fiber, and seasoned foods
• Avoid caffeine products b/c they already have tachycardia

Question 5

what are diagnostic for hyperthyroidism?

Answer 5

Labs:
- High T3 & T4
- Low TSH
RAIU test: helps distinguish cause as Graves’s disease or other causes of thyrotoxicosis

Question 6

What is Thyroid storm, cause and s/s?

Answer 6

• Thyroid storm is an acute, severe, and rare condition that occurs when excessive amounts of thyroid hormones are released into circulation.
• This can be life-threatening EMERGENCY! if not treated early.

Cause by stressor: infection, trauma, surgery: post thyroidectomy

S/S
- severe tachycardia, dysrhythmia, HEART FAILURE, shock, hyperthermia, agitation, delirium, seizures, abdominal pain, vomiting, diarrhea, and coma

Question 7

what are the Thyroid storm diagnostic requirements?

Answer 7

Labs: low or undetectable TSH, Increased free T4 levels.

Radioactive iodine uptake (RAIU test)
- this is not for pregnant women: avoid food and supplement with iodine before the test.

Question 8

How do we treat thyroid storm (thyrotoxicosis crisis)?

Answer 8

We will manage respiratory distress, reduce fever, fluid replacements, eliminating or managing the etiology or stressor.

Question 9

What is Graves disease?

Answer 9

Graves’ disease is an autoimmune disorder where the body’s immune system mistakenly attacks the thyroid gland, causing it to overproduce thyroid hormones, leading to hyperthyroidism (an overactive thyroid).

Remember Grave’s disease is what causes the hyperthyroidism!

Question 10

What are the s/s of graves disease?

Answer 10

symptoms of Graves’ disease is usually gradual, often taking several weeks or months to develop.

• Visualization and Palpation of the thyroid may reveal goiter, bruits with auscultation.
• Exophthalmos: Bulging eyes
• Rapid heart beat (palpatation)
• Enlarged Thyroid gland (Giotor)
• Tremors
• Weight loss