Med Surg Chapter 43 Flashcards
Euthyroidism
normal gland function
describe endemic goiter
caused by lack of nutritional iodine. commonly seen in adolescents and pregnant or nursing women due to the growth spurts
describe sporadic goiter
can be found in any region. caused by genetics or ingestion of goitrogens
how do goitrogens function and what are examples
they inhibit T4 production.
cabbage, soybeans, spinach;
glucocorticoids, dopamine, lithium
primary hypothyroidism
low TH, high TSH. most common is primary auto-immune
secondary hypothyroidism
low TH, low TSH. TSH is not performing properly
Tertiary or Central hypothyroidism
low TH, low TSH. hypothalamus cannot produce thyroid releasing hormone
low TH levels cause increases in what other levels and conditions
cause an increase in cholesterol and triglycerides and an increase in atherosclerosis, arteriosclerosis, and heart disease
what are some s/sx of hypothyroidism
patient may complain of cold, lethargy, constipation, forgetfulness, depression, dry skin, and wt gain
what is myxedema
dry, waxy swelling with abnormal deposits of mucin in the skin. edema is non-pitting and common in pretibial and facial areas
what can lead up to a myxedema coma
infection, trauma, stress, or surgery
why is levothyroxine sodium (synthroid) commonly used to treat hypothyroidism
synthroid is converted to both T3 and T4 in the body
how long does it take for physical effects to decrease once tx is started with synthroid
about 3-12 weeks
what should be monitored when giving T4 to the elderly and why
pulse rate should be monitored daily
ischemic heart disease as evidenced by angina may develop
what population does hyperthyroidism generally affect
women 20-40 years old
what is the most common form of hyperthyroidism
Grave’s disease
Grave’s disease has what 3 general characteristics
goiter, exopthalmos, hyperthyroidism
what problems can be caused by elevated TH related to sexual function
diminished libido, irregular periods, decreased fertility, delay in sexual development if before puberty
what are common s/sx of hyperthyroidism
agitation, irritability, hand tremors at rest, increased appetite, wt loss, loose stools, heat intolerance, tachycardia
what are the major c/o of Grave’s disease
heart disease, thyroid storm, exopthalmos
define exopthalmos
protruding eyes in a fixed stare
condition usually does not regress with therapy
what are some symptoms of exopthalmos
photophobia, gritty sensation in the eye, and lacrimation
what are some interventions for pt with exopthalmos
have pt wear dark sunglasses, elevate head of bed, wear eyemask when sleeping or tape lids shut, decrease salt intake to help with edema
how is thyroid storm or thyrotoxicosis diagnosed
only by s/sx. there is no clinical diagnosis. no labs to confirm
