Hyperthyroidsim Flashcards
What is hyperthyroidism ?
++ production of T3 & T4 by thyroid gland
What are some of the cause of hyperthyroidism ?
- Graves’ disease
- tumours
- toxic adenoma of thyroid
What are the S+S of hyperthyroidism/graves disease
- 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
What are the 2 treatment options in relation to hyperthyroidism ?
- conservative ( meds , radioactive iodine treatment )
- surgical ( thyroid lobectomy, total thyroidectomy )
What is the medication given to treat hyperthyroidism ?
Thionamides (Anti-thyroid meds )
What is the function of thionamides
Stop thyroid from producing excess hormones
- 1-2 months b4 noticing benefits
- grad reduced + stopped when thyroid hormone lvls under control
What is the function of radioactive iodine therapy ?
The radiotherapy destroys cells in the thyroid gland which reduces the lvl of hormones it can produce
How does radioactive iodine therapy work ?
Drink capsule w iodine + low dose of radiation is absorbed by the thyroid
What is a thyroid lobectomy?
One lobe of thyroid gland removed
What is a total thyroidectomy ?
Both lobes + the isthmus of thyroid gland removed
What is the assessment done b4 surgery ?
-Bloods
-scanning + imagery
-needle biopsy
What is the pre-op nursing mgt?
- 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
How is hyperthyroidism diagnosed ?
Blood tests ordered testing T3, T4 and TSH lvls in blood
What is the patient education for taking thionamides ?
- 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
What are the nursing interventions 4 hyperthyroidism?
-keep pt comfy : cool, quiet environment, sedatives
- daily wgts
-monitor vitals
-educate pt about meds nd tx
-monitor 4 thyroid storm
What is a thyroid storm/ crisis ?
- 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
What are the S&S of a thyroid crisis/storm
- fever
-^ HR - ^BP
- very restlesss
- exaggerated S&S of hyperthyroidism
What are post-op complications of thyroid surgery ?
-airway obstruction
-haemorrhage
-recurrent laryngeal nerve damage
- thyroid storm/crisis
-tetany
What are the post-op mgt 4 resp difficulties ?
- 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
What are the post-op mgt 4 risk of haemorrhage ?
- 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 !!
What r the nursing mgt 4 risk of tetany ?
- monitor 4 signs of numbness/tingling + muscle twitching
- monitor 4 abdo cramps
- treat w calcium glauconite 10% IV slowly- admin by doc
What r nursing mgt 4 diff swallowing bcs of pain
- 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
What is the pain mgt post -op
- pain assessment reg w pain scale
- admin analgesia & monitor + document effect
- ensure pt comfy
- reassure + psychological support
What is Grave’s disease ?
- autoimmune disorder
- immune sys attacks the thyroid + causes it to make ++ thyroid hormone
What is mgt post - op - psychological - alt body image
- 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
