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NUR 326 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

what is the thyroid

A

2 in butterfly shaped gland that release T3 and T4

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2
Q

what is T3

A

triiodothyronine
- active form

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3
Q

what is T4

A

thyroxine
- free and bound
- gets converted to T3 at the tissue when it loses an I atom

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4
Q

what does T4 do

A

regulates the body’s metabolism

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5
Q

what is the necessary component in the synthesis of thyroid hormone

A

iodine

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6
Q

review of the thyroid feedback system

A
  • hypothalamus releases thyroid releasing hormone (TRH)
  • TRH stimulates anterior pituitary to release thyroid stimulating hormone (TSH)
  • TSH stimulates the thyroid gland to produce T4
  • T4 levels will dictate TRH and TSH release
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7
Q

what are the thyroid dysfunctions

A
  • either hypo or hyper
  • primary disorders are most common (thyroid gland itself)
  • more women
  • enlargement of thyroid w disorders
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8
Q

what is a goiter

A

enlargement of thyroid caused by low I levels that prevents release of T4 or build up of TSH
- no sx = non toxic

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9
Q

what is a goitrogen

A

foods and other substances that cause an enlargement of thyroid
- ex lithium

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10
Q

what is hypothyroidism

A

T3 and T4 levels are low

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11
Q

primary disorder hypothyroidism

A

inc release of TSH from pituitary and dec in T3 and T4

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12
Q

secondary disorder hypothyroidism

A

hashimoto’s
- autoimmune disorder, most common cause, abx attack thyroid, low T3/4 inc TSH

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13
Q

what to look for with hashimoto’s

A
  • thyroid receptor antibodies
  • antithyroglobulin antibody
  • antipyrotheroxidase antibody –> hallmark
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14
Q

risk factors for hypothyroidism

A

female
over 50
white
pregnant
hx of autoimmune disorders
fam hx
medications
treatments for hyperthyroidism

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15
Q

early manifestations of hypothyroidism

A

cold intolerance
wt gain
lethargy
fatigue
poor attention span
inc cholesterol
muscle cramps
raise in carotene levels –> cause yellow skin
C
dec fertility
puffy face (facial and eyebrow edema)
brittle nails

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16
Q

later hypothyroid manifestations

A

below normal temp
bradycardia
wt gain
dec LOC
thickening skin
cardio complications –> cardiomegaly

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17
Q

hypothyroidism affects all organs

A

raises cholesterol
raises carotene
causes anemia
dec filtration of kidneys
cause hoarse voice

18
Q

what is myxedema

A

a coma that results from untreated hypothyroidism
- lose of brain function
- dermatological changes

19
Q

diagnosis of hypothyroidism

A

high TSH level
low T3 and T4
antithyroglobulin
antithyroperoxidase

20
Q

what happens with primary and secondary hypothyroidism

A

primary: high TSH and low T3 and T4
secondary: TSH and T4 are low

21
Q

what is the treatment of hypothyroidism

A

replacement hormone therapy –> levothyroxine

22
Q

levothyroxine moa

A

converted to T3 in body

23
Q

levothyroxine nursing considerations

A

half life 7 days
takes about a month to work
se: too high then can cause hyperthyroidism –> need to get correct dose
food and other drugs and affect absorption so take on empty stomach (30 mins before eating)
for warfarin: inc risk for bleeding
drugs taken for life

24
Q

hyperthyroidism

A

excessive secretion of T3 and T4
- primary cause: thyroid producing too much T3 and T4
- secondary: pituitary over releasing TSH, rare
- tertiary: excess secretion TRH

25
Q

what is graves disease

A

autoimmune stimulation of thyroid gland
- most common
- excessive levels of T3 and T4
- thyroid stimulating antibodies bind to activate receptors in thyroid that cause continuous secretion

26
Q

other causes of hyperthyroidism

A

thyroid adenoma, subacute thyroiditis, toxic multi nodular goiter (cancer), excessive I secretion, excessive thyroid replacement

27
Q

risk factors of hyperthyroidism

A

over 40
female
white
medications
excessive I intake
pregnancy –> hormones similar to TSH and stimulate recpetors

28
Q

graves disease symptoms

A

nervousness
insomnia
sensitivity to heat
wt loss
gland is usually enlarged
bruit over thyroid
atrial fibrillation
myxedema
exophthalmos
enhanced sensitivity to anticholinamines

29
Q

what is exophthalmos

A

wide eyed stare associated with inc sympathetic tone and infiltration of extraocular area with lymphocytes and mucopolysaccharides

30
Q

what is graves ophthalmopathy

A

periorbital edema and bulging of the eyes
- more likely seen in women

31
Q

diagnosising of graves disease

A

low TSH
high T3 and T4
antithyroglobulin
antithyrotropin receptor antibody
ultrasound with color doppler eval
radioactive iodine scanning and measurements of I uptake (inc with Graves)

32
Q

treatment of hyperthyroidism

A

give propylthiouracil
radioactive I –> destroys some of the tissue
surgery –> if removed then need replacement

33
Q

what does propylthiouracil do

A

blocks thyroid hormone synthesis, suppresses conversion of T4 to T3

34
Q

propylthiouracil adverse effects

A

hepatotoxicity
caution during 1st trimester but should be changed

35
Q

what is thyrotoxic crisis

A

overwhelming release of thyroid hormones that exerts an intense stimulus of the metabolism
- release of stress hormones (anticholinamines)
- life threatening commonly precipitated by surgery, trauma, infection (stressors)

36
Q

what is the parathyroid gland

A

small glands that secrete parathyroid gland (PTH) which controls Ca levels in the body and promotes vit D production by kidneys

37
Q

what is hypoparathyroidism

A

insufficient levels of PTH resulting in hypocalcemia

38
Q

sx of hypoparathyroidism

A

muscle cramps
irritability
tetany (trousseau –> hand, chvosteks)
convulsions
inc phosphate levels

39
Q

hypoparathyroid treatment

A

replace PTH to normalize Ca and Vit d

40
Q

hyperparathyroidism

A

too much PTH so excessive Ca in blood

41
Q

sx of hyperparathyroidism

A

muscle weakness
poor concentration
neuropathies
HTN
kidney stones
metabolic acidosis
osteopenia (bone breakdown)
pathological fractures
C
depression, confusion, subtle cognitive deficits

42
Q

hyperparathyroidism treatment

A

reduce Ca levels
diuretics –> dec levels
calcitonin
bisphosphate –> reduce bone breakdown, by reducing osteoclast activity
vit d
surgical intervention

NUR 326 (20 decks)

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