Med-Surg Lesser Known

Question 0

Hyperthyroidism: Nursing Assessment

Answer 0

A. Enlarged thyroid gland
B. Acceleration of body processes
1. Weight loss
2. Increased appetite
3. Diarrhea
4. Heat intolerance
5. Tachycardia, palpitations, increased BP
6. Diaphoresis, wet or moist skin
7. Nervousness, insomnia
C. Exophthalmos (Fig. 4-5)
D. T3 elevated above 220 ng/dL
E. T4 elevated above 12 mcg/dL
F. Low level of TSH indicates primary disease; elevated
T4 level suppresses thyroid-releasing hormone (TRH), which suppresses TSH secretion. If source is anterior pituitary, both will be elevated.
G. Radioactive iodine uptake (131I) (indicates presence of goiter)
H. Thyroid scan (indicating presence of goiter)

Question 1

What is hyperthyroidism / Graves disease / goiter (endocrine)?
Patho
Dx
Tx

Answer 1

Description: Excessive activity of thyroid gland, resulting in an elevated level of circulating thyroid hormones. Possibly long-term or lifelong treatment.
A. Hyperthyroidism can result from a primary disease state; from the use of replacement hormone therapy; or from excess thyroid-stimulating hormone (TSH) being produced by an anterior pituitary tumor.
B. Graves disease is thought to be an autoimmune process and accounts for most cases.
C. Diagnosis is made on the basis of serum hormone levels
D. Common treatment for hyperthyroidism—goal is to create a euthyroid state
1. Thyroid ablation by medication 2. Radiation
3. Thyroidectomy
4. Adenectomy of portion of anterior pituitary where TSH-producing tumor is located
E. All treatments make the client hypothyroid, requiring hormone replacement.