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Med Surg Test 5: Endocrine > Med Surg: Care of Patients with Thyroid and Parathyroid Problems > Flashcards

Med Surg: Care of Patients with Thyroid and Parathyroid Problems Flashcards

1
Q

What does the Thyroid Gland?

A

Control of metabolism

Produces thyroxine, triiodothyronine and thyrocalcitonin

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2
Q

What is hypothyroidism?

A

Hypothyroid state resulting from a hyposecretion of the thyroid horomone T3 and T4

Characterized by a decreased rate of body metabolism

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3
Q

What is the assessment of hypothyroidism

A

Lethargy and fatigue

Personality and mental changes, forgetfulness

Slowed speech, decreased initiative, somnolence

Bradycardia, cardiac enlargement, tendency to develop CHF

Anemia

Decreased GI motility

Weakness, muscle aches, paresthesias

Intolerance to cold

Weight gain

Dry skin and hair, loss of body hair, brittle nails

Constipation, decrease GI motility

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4
Q

Interventions of hypothyroidism?

A

Monitor VS including HR and rhythm

Administer thyroid replacement

Instruct about thyroid replacement therapy

Instruct clinet in low-calorie, low-cholesterol, low-saturated-fat diet

Assess for constipation: provide roughage and fluids

Provide a warm environment

Avoid sedatives and narvotics

Monitor for overdose and thyroid meds

Instruct to report chest pain immediately

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5
Q

What is a myxedema coma?

A

rare but serious disorder that results from persistently low thyroid production

Coma can be precipitated by acute illness, rapid withdrawal of thyroid medicaiton, anesthesia and surgery, hypothermia and the use of sedatives and narcotics

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6
Q

What is the assessment of myxedema coma?

A

hypotension

bradycardia

hypothermia

hyponatremia

hypogymcemia

generalized edema

respiratory failure

coma

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7
Q

Interventions for myxedema coma?

A

maintain patent airway

administer IV fluids

Administer levothyroxine sodium IV

Administer glucose IV

Assess client’s temperature frequently

Monitor blood pressure

Keep client warm

Monitor for mental status changes

Monitor electrolytes and glucose level

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8
Q

What is hyperthyroidism?

A

resulting from hypersecretion of thyroid hormones

characterized by increased rate of body metabolism

Common cause is Grave’s disease

Clinical manifestations are called thyrotoxicosis

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9
Q

What is the assessment of hyperthyroidism?

A

Enlarged thyroid gland

Palpitations, cardiac dysrhthmias

Protruding eyeballs

Pretibilal myxedema

Hypertension

Heat intolerance

Diaphoresis

Weight loss

Diarrhea

Smooth, soft skin and hair

Nervousness and fine tremors of hands

Personality changes-irritability and agitation, mood swings

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10
Q

What are the interventions of hyperthyroidism?

A

adequate rest

administer sedatives as prescribed

cool, quiet environment

daily weight

high calorie diet

avoid administration of stimulants

administer antithyroid medications

administer iodine preparation that inhibit the release of thyroid hormone

administer propranlol for tachycardia as prescribed

Prepare the clinet for radioactive iodine therapy to destroy thyroid cells

Prepare the client for thyroidectomy

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11
Q

What is a thyroid storm?

A

acute and life threatening condition that occurs in a client with uncontrollable hyperthyroidism

Occcurs from manipulation of the thyroid gland during surgery and the release of thyroid hormone into the bloodstream or from severe infection and stress

Antithyroid medications, Beta-blockers, glucocorticoids, and iodides are administered pro-op thyroid surgery to prevent it

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12
Q

What is the assessment for Thyroid Storm?

A

Elevated temperature

Tachycardia

Systolic hypertension

N&V, diarrhea

Agitation, tremors and anxiety

Irritability, agitation, restlessness, confusion, and seizures as it progresses

Delirium and coma

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13
Q

What are the interventions for a Thyroid Storm?

A

Maintain pt airways and adquate ventilation

Administer antithyroid medications, sodium iodide solution, propranolol and glucocorticoids

NS infusion to combat dehydration

Monitor VS

Continual cardiac monitoring for dysrhythmias

Administer nonsalicylate antipyretics

Cooling blanket to decrease fever

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14
Q

What is thyroidectomy?

A

Removal of the thyroid gland

Performed for persistent hyperthyroidism

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15
Q

What are pre-op interventions for Thyroidectomy?

A

VS and weight

Electrolyte levels

Assess for hyperglycemia and glycosuria

Instruct on C&DB exercises, how to support the neck when coughing and moving

Administer antithyroid medications, sodium iodide solution, propranolol and glucocorticoids to prevent thyroid storm

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16
Q

What is the post-op intervention for thyroidectomy?

A

monitor for respiratory distress

have a trach set, oxygen and suction at bedside

maintain client in semi-fowler position

Monitor surgical site for edema and signs of bleeding

limit client talking and assess level of hoarseness

monitor for laryngeal nerve damage

monitor for signs of hypocalcemia and tetany

prepare to administer calcium gluconate tetany monitor for thyroid storm

17
Q

What are the signs of tetany?

A

cardiac dysrhythmias

carpopedal spasm

Dysphagia

Muscle and abdominal cramps

Numbness and tingling of the face and extremetities

Postitive Chvosteks sign

Positive Trousseus sign

Seizures

Visual disturbances

Wheezing and dyspnea

18
Q

What is a parathyroid gland?

A

Calcium and phosphorus balance

Produce parathroid hormone

19
Q

What is hypoparathyroidism?

A

Condition caused by hyposecretion of parathyroid hormone by parathyroid gland

Can occur after thyroidectomy because of removal of parathyroid tissue

20
Q

What does the parathyroid gland?

A

calcium and phosphorous balance

profuce parathroid hormone

21
Q

What is Hypoparathyroidism?

A

condition caused by hyposecretion of parathyroid hormone by parathyroid gland

can occur after thyroidectomy because of removal of parathyroid tissue

22
Q

What is the assessment of hypoparathyroidism?

A

Hypocalcemia and hyperphosphatemia

Numbness and tingling of the face

Muscle cramps and cramps in abdomen or extremities

Positive Trousseau’s sign or Chvostek’s sign

Signs of overt tetany

Hypotension

Anxiety, irritability and depression

23
Q

What are intervetnios for hypoparathyroidism/

A

monitor VS

monitor signs of hypocalcemia and tetany

initiate seizure precautions

place a trach set, oxygen and suction at bedside

Prepare to administer calcium gluconate IV for hypocalcemia

provide a high calcium, low phosphous diet

Instruct client in administration of calcium supplement

Instruct client on administration of Vit D supplement

Instruct cleitn on administration of phosphate binders

Instruct client to wear a medic-alert bracelet

24
Q

What is hyperparathyroidism?

A

Coniditon caused by hypersecretion of parathyroid hormone by the parathroid gland

25
Q

What are the assessment for hyperparathyroidism?

A

hypercalcemia dn hypophosphatemia

fatigue and muscle weakness

skeletal pain and tenderness

bone deformities that result in pathological fratiures

anorexia, N&V, epigastric pain

weight loss

Constipation

hypertension

Cardiac dysrhythmias

renal stones

26
Q

What are the interventions of hyperparathyroidism?

A

monitor VS esp BP

monitor for cardiac dysrhymias

monitor I&O and for sign of renal stones

monitor for skeletal pain, move client slow and careful

Encourage fluid intake

Administer furosemide

administer normal saline IV for hydration

administer phosphates

administer calcitonin

monitor caluim and phosphorus levels

assess for sign of hypocalcemia

prepare the client for parathyroidectomy

27
Q

What is a parathyroidectomy?

A

removal of one or more of the parathyroid glands

28
Q

What are the pro-op interventions for parathyroidectomy?

A

Monitor electrolytes, calcium, phosphate and magnesium levels

Ensure that calcium levels are decreased to near normal

Inform the client that talking may be painful for 1-2 post surgery

29
Q

What are post-op interventions for parathyroidectomy?

A

Monitor for respiratory distress

Place a trach set, oxygen and suction at bedside

Position in semi-fowler position

Assess neck dressing for bleeding

Monitor for hypocalcemic crisis

Assess for positive Trousseu’s or Chvosteks’s sign

Monitor for changes in voice pattern and hoarseness

Monitor for laryngeal nerve damage

Instrust the client in the administration of calcium and Vitamin D supplements

Med Surg Test 5: Endocrine (4 decks)

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