Hyperthyroidsim

Question 1

What is hyperthyroidism ?

Answer 1

++ production of T3 & T4 by thyroid gland

Question 2

What are some of the cause of hyperthyroidism ?

Answer 2

• Graves’ disease
• tumours
• toxic adenoma of thyroid

Question 3

What are the S+S of hyperthyroidism/graves disease

Answer 3

• anxiety + irritability
  -fine tremor
  -heat sensitivity + ^ in sweat/warm or moist skin
• wgt loss even w norm diet
• goitre
  -change in menstrual cycles
• erectile dysfunction and reduced libido
• freq bowel movements
• bulging eyes ( graves ophthalmopathy)
• fatigue
• thick red skin ( Graves dermopathy)
• heart palpitations

Question 4

What are the 2 treatment options in relation to hyperthyroidism ?

Answer 4

• conservative ( meds , radioactive iodine treatment )
• surgical ( thyroid lobectomy, total thyroidectomy )

Question 5

What is the medication given to treat hyperthyroidism ?

Answer 5

Thionamides (Anti-thyroid meds )

Question 6

What is the function of thionamides

Answer 6

Stop thyroid from producing excess hormones
- 1-2 months b4 noticing benefits
- grad reduced + stopped when thyroid hormone lvls under control

Question 7

What is the function of radioactive iodine therapy ?

Answer 7

The radiotherapy destroys cells in the thyroid gland which reduces the lvl of hormones it can produce

Question 8

How does radioactive iodine therapy work ?

Answer 8

Drink capsule w iodine + low dose of radiation is absorbed by the thyroid

Question 9

What is a thyroid lobectomy?

Answer 9

One lobe of thyroid gland removed

Question 10

What is a total thyroidectomy ?

Answer 10

Both lobes + the isthmus of thyroid gland removed

Question 11

What is the assessment done b4 surgery ?

Answer 11

-Bloods
-scanning + imagery
-needle biopsy

Question 12

What is the pre-op nursing mgt?

Answer 12

• anti-thyroid drugs given wks b4 surgery
• potassium iodine given 4 approx 10 days b4 surgery to reduce the size and vascularity of gland
• blood type and cross match
• ECG + CXR
• Pt education- breathing exercises, about surgery etc
• consent + pre-op checklist

Question 13

How is hyperthyroidism diagnosed ?

Answer 13

Blood tests ordered testing T3, T4 and TSH lvls in blood

Question 14

What is the patient education for taking thionamides ?

Answer 14

• never stop taking them abruptly
  -take at the same time QD
• monitor for thyroid storm
• avoid iodine rich foods
• look out 4 S&S of hypothyroidism

Question 15

What are the nursing interventions 4 hyperthyroidism?

Answer 15

-keep pt comfy : cool, quiet environment, sedatives
- daily wgts
-monitor vitals
-educate pt about meds nd tx
-monitor 4 thyroid storm

Question 16

What is a thyroid storm/ crisis ?

Answer 16

• emergency
• ++ thyroid hormones secreted and released into the blood :leaves pt in an acute thyrotoxic state
• as result of untreated hyperthyroidism
• can occur 6-12 hrs post op after thyroidectomy

Question 17

What are the S&S of a thyroid crisis/storm

Answer 17

• fever
  -^ HR
• ^BP
• very restlesss
• exaggerated S&S of hyperthyroidism

Question 18

What are post-op complications of thyroid surgery ?

Answer 18

-airway obstruction
-haemorrhage
-recurrent laryngeal nerve damage
- thyroid storm/crisis
-tetany

Question 19

What are the post-op mgt 4 resp difficulties ?

Answer 19

• pt sitting upright (Fowlers position)
• support head & neck w pillows
• no strain on wound site
• O2 as prescribed
• check resps - rate/dept etc
• check 4 cyanosis
• encourage deep breathing
• O2 & suction @ bedside
• emergency tracheostomy set on ward

Question 20

What are the post-op mgt 4 risk of haemorrhage ?

Answer 20

• staple removers/stitch cutters @ bedside
• monitor BP and Pulse v v closely
• obs resps
• check wound site 4 signs of fresh bleeding
• check around & behind neck 4 collection of blood
• if haematoma forming call doctor asap !!

Question 21

What r the nursing mgt 4 risk of tetany ?

Answer 21

• monitor 4 signs of numbness/tingling + muscle twitching
• monitor 4 abdo cramps
• treat w calcium glauconite 10% IV slowly- admin by doc

Question 22

What r nursing mgt 4 diff swallowing bcs of pain

Answer 22

• ensure hydration and nutritional status maintained :
• I & O chart
• monitor IV - ensure infusing @ correct rate
• obs 4 phlebitis ( around cannula site )
• reg oral hygiene
• check gums, tongue + lips 4 sores
• soft diet - 48hrs
• anti emetics as prescribed

Question 23

What is the pain mgt post -op

Answer 23

• pain assessment reg w pain scale
• admin analgesia & monitor + document effect
• ensure pt comfy
• reassure + psychological support

Question 24

What is Grave’s disease ?

Answer 24

• autoimmune disorder
• immune sys attacks the thyroid + causes it to make ++ thyroid hormone

Question 25

What is mgt post - op - psychological - alt body image

Answer 25

• encourage pt 2 look at scar
• allow pt time 2 express worries + fears
• discuss pos of disguising scar eg. W scarf
• reassurance + support
• explain follow up