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NSG 430 - Critical Care > T2: Thyroid > Flashcards

T2: Thyroid Flashcards

1
Q

medication for hypothyroid

A

levothyroxine (synthroid)

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2
Q

medications for hyperthyroid

A

methimazole (Tapazole) &
Propylthiouracil

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3
Q

thyrotoxicosis results from

A

increased circulating levels of T3, T4, or both (hyper metabolism)

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4
Q

graves disease

A

autoimmune disease of unknown etiology characterized by diffuse thyroid enlargement and excess thyroid hormone secretion (hyperthyroid)

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5
Q

precipitating factors for graves disease

A

insufficient iodine supply, cigarette smoking, infection, and stressful life events

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6
Q

Related to effect of thyroid hormone excess

A

↑ Metabolism
↑ Tissue sensitivity to stimulation by sympathetic nervous system

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7
Q

goiter

A

enlarged thyroid gland, auscultating the thyroid gland may reveal bruits, a reflection of increased blood supply.

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8
Q

exophthalmos is present in

A

hyperthyroidism

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9
Q

complications of exophthalmos

A

dry eyes, corneal abrasion , eyes might not close when sleeping

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10
Q

clinical manifestations of hyperthyroidism

A

-rapid pulse
-dyspnea on exertion, increased RR
-increased appetite, weight loss, diarrhea
-warm skin, thins skin and nails
-pretibial myxedema -insomnia
-personality changes
-amenorrhea
-intolerance to heat

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11
Q

acute thyrotoxicosis (thyroid storm/crisis)

A

an acute, severe, and rare condition that occurs when excessive amounts of thyroid hormones are released into the circulation MEDICAL EMERGENCY

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12
Q

what needs to be done with a patient in thyroid storm

A

take out the thyroid (thyroidectomy)

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13
Q

what needs to be monitored when taking out the thyroid

A

calcium levels because of the parathyroid (this can affect the heart)

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14
Q

manifestations of acute thyrotoxicosis

A

-Severe tachycardia, heart failure
-Shock
-Hyperthermia
-Agitation
-Seizures
-Abdominal pain, vomiting, diarrhea
-Delirium, coma

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15
Q

what are ehe two primary laboratory findings used to confirm the diagnosis of hyperthyroidism

A

*low or undetectable TSH levels (< 0.4 mIU/L) and elevated free thyroxine (free T4) levels.

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16
Q

The RAIU test is used to

A

differentiate Graves’ disease from other forms of thyroiditis.
-The patient with Graves’ disease will show a diffuse, homogeneous uptake of 35% to 95%, whereas the patient with thyroiditis will show an uptake of less than 2%.

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17
Q

what are the primary treatment options for hyperthyroidism

A

-Antithyroid medications
-Radioactive iodine therapy (RAI)
-Surgery

18
Q

drug therapy for hyperthyroidsm

A

-Anti-thyroid drugs
-Iodine
-β-Adrenergic blockers
(not curative)

19
Q

improvement of antithyroid drugs

A

-Improvement in 1 to 2 weeks
-Good results in 4 to 8 weeks

20
Q

Potassium iodine (SSKI) and Lugol’s solution

A

Inhibit synthesis of T3 and T4 and block their release into circulation, Decreases vascularity of thyroid gland

21
Q

Before thyroid surgery what is given

A

Iodine is used with other antithyroid drugs to prepare the patient for thyroidectomy

22
Q

signs of iodine toxicity

A

swelling of the buccal mucosa and other mucous membranes, excessive salivation, nausea and vomiting, and skin reactions

23
Q

indications for surgical therapy: thyroid

A

-Large goiter causing tracheal compression
-Unresponsive to anti-thyroid therapy
-Thyroid cancer
-Not a candidate for RAI

24
Q

Subtotal thyroidectomy

A

Preferred surgical procedure
Involves removal of 90% of thyroid

25
Q

how can we check calcium levels without a blood draw

A

trousseau and chvostek

26
Q

Nursing Implementation: Acute Thyrotoxicosis-Thyroid storm

A

-thyroidectomy
-anti thyroid medications
-monitor for dysrhythmias
-fluid and electrolyte replacement (from vomit and diarrhea)

27
Q

environment for hyperthyroidism/thyrotoxicosis

A

*Calm, quiet room
*Cool room
*Light bed coverings
ensure adequate rest

28
Q

If exophthalmos present:

A

-Apply artificial tears to relieve eye discomfort
-Salt restriction and elevate head of bed
-Dark glasses
-Tape eyelids closed if needed for sleep
-ROM of intraocular muscles

29
Q

Hypothyroidism/Myxedema Coma

A

-Deficiency of thyroid hormone
-Causes general slowing metabolic rate

30
Q

Primary hypothyroidism is caused by

A

destruction of thyroid tissue or defective hormone synthesis.

31
Q

Secondary hypothyroidism is caused by

A

pituitary disease with decreased TSH secretion or hypothalamic dysfunction with decreased thyrotropin-releasing hormone (TRH) secretion.

32
Q

what is the most common cause of hypothyroidism

A

Iodine deficiency

33
Q

hypothyroidism autoimmune

A

Hashimoto’s

34
Q

cretinism

A

Hypothyroidism that develops in infancy, is caused by thyroid hormone deficiencies during fetal or early neonatal life.

35
Q

Clinical Manifestations of hypothyroidism

A

slowing of body processes
fatigue, cold and dry skin, hoarseness, hair loss, constipation, and cold intolerance

36
Q

since everything is slowed down in hypothyroidism we lose

A

end organ perfusion

37
Q

myxedema coma is precipitated by

A

infection, drugs, cold, trauma

38
Q

myxedema coma is characterized by

A

-Impaired consciousness
-Subnormal temperature, hypotension, hypoventilation
-Cardiovascular collapse-from hypoventilation, hyponatremia, hypoglycemia, and lactic acidosis

39
Q

treatment for myxedema coma

A

IV levothyroxine (thyroid hormone)

40
Q

Levothyroxine (Synthroid)

A

-Start with low dose
-Monitor for cardiovascular side effects (chest pain, dysrhythmias), weight loss, nervousness, tremors, insomnia
-Increase dose in 4- to 6-week intervals as needed
-Lifelong therapy

41
Q

Myxedema coma necessitates acute care

A

-Mechanical respiratory support
-Cardiac monitoring
-IV thyroid hormone replacement
-Monitoring of CORE TEMP

NSG 430 - Critical Care (42 decks)

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