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Pharmacology exam 3 > Thyroid: 5 Questions > Flashcards

Thyroid: 5 Questions Flashcards

1
Q

If the thyroid is under active?

A

TSH is High

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2
Q

If the thyroid is over active ?

A

TSH is Low

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3
Q

T3 and T4 are Low and TSH is High?

A

Hypothyroidism

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4
Q

T3 and T4 are high and TSH is Low?

A

Hyperthyroidism

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5
Q

What are the effects on the body of Hypothyroidism ?

A

Everything slows down: Weight gain, get colder, constipation, decrease LOC, bradycardia.

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6
Q

What is Goiter?

A

Enlargement of thyroid gland resulting from too much TSH due to too little thyroid hormones in circulation.

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7
Q

What is the disease associated with Hypothyroidism?

A

Myxedema Coma/Crisis

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8
Q

What is Myxedema Coma?

A

A severe life threatening complication of untreated hypothyroidism.

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9
Q

Who is more commonly affected by Myxedema Coma?

A

Patients over 50 and in women

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10
Q

What time of year is Myxedema Coma increased ?

A

Winter due to extreme temperatures.

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11
Q

What could happen if a patient goes into a Myxedema Coma?

A

Loss of brain function or death can occur.

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12
Q

What are the S/S of Myxedema Coma?

A

~Hypothermia
~Severe mental changes=Deep Coma
~Edema all over the body
~Thin and dry hair, loss of eyebrows
~ Difficulty breathing
~Bradycardia
~GI stops working

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13
Q

What is the medication for Hypothyroidism ?

A

Levothyroxine (Synthroid)

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14
Q

How should Levothyroxine (Synthroid) be administered?

A

1x daily PO in the morning 30-60 minutes before a meal at the same time every day.

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15
Q

Is there a cure for Hypothyroidism ?

A

No, will have to remain on drugs.

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16
Q

What does Levothyroxine (Synthroid) mimic?

A

T4 (Thyroxine)

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17
Q

What is the dosage for Levothyroxine (Synthroid)?

A

25-200 mcg/day, anything over is questioned

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18
Q

Is Levothyroxine (Synthroid) safe for pregnancy ?

A

Yes

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19
Q

What should the nurse monitor while a patient is taking Levothyroxine (Synthroid)?

A

Thyroid panel, Vitals, weight, height, T3,T4, TSH, and cardiac excitability (Rapid heartbeat, tachycardia)

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20
Q

What are the adverse effects to Hyperthyroidism?

A

Overdose: Cardiac dysthymias (tachycardia, palpations), tremors, anxiety, weight loss.

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21
Q

Should someone take thyroid meds for weight loss?

A

NO

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22
Q

What interactions does thyroid medications have with other medications?

A

May enhance anticoagulants=thin the blood more.

23
Q

What happens when someone takes too much thyroid medication?

A

increased metabolic rate, temperature, and pulse, restlessness, anxiety, emotional instability

24
Q

What is exophthalmos?

A

Bulging eye=indicates long term hyperthyroidism.

25
Q

What are the things or effects that occur to the body with hyperthyroidism?

A

Everything becomes fast: Bulging eyes, finger clubbing, weight loss, increase temp, diarrhea, tachycardia.

26
Q

What happens to women when it comes to Hypo and Hyperthyroidism?

A

Menstral Cycles get messed up.

27
Q

What is Thyroid Storm?

A

A severe life threatening emergency due to Hyperthyroidism. This is because of undertreated, untreated, or an infection because of Hyperthyroidism.

28
Q

How should a Nurse handle a patient with Thyroid Storm?

A

Once symptoms are recognized, treatment should begin immediately and should not be delayed by waiting for the return of lab results

29
Q

What are the cardinal symptoms of thyroid storm?

A

High fever-103, tachycardia, AFIB, CHF, Neuro symptoms, and GI symptoms (diarrhea)

30
Q

What sounds would you hear from the lungs with someone having thyroid storm?

A

Build up in the lungs, crackles.

31
Q

What things could trigger thyroid storm ?

A
  • Trauma, burns
  • Surgeries
  • Stroke
  • Acute brain injury
  • Others
32
Q

How do you treat Thyroid Storm?

A

~IV fluids
~Acetaminophen-fever
Oxygen
~Cooling blankets-lower body temp.

33
Q

What is the goal for treating Hyperthyroidism ?

A

Eliminating excess thyroid hormone

34
Q

What things can help treat Hyperthyroidism?

A

~Surgery
~Methimazole (Tapazole)
~PROPYLTHIOURACIL (PTU)
~Radioactive Iodine

35
Q

What is the MOA of Methimazole (Tapazole)?

A

Impede the formation of thyroid hormone.

36
Q

What is the reason to take Methimazole (Tapazole)?

A

Lower thyroid levels and Lower/normalize metabolic rate.

37
Q

What is Methimazole (Tapazole) and PTU used in preparation for?

A

Thyroidectomy or radioactive iodine therapy

38
Q

What is the risk when it comes to Methimazole (Tapazole) and PTU?

A

Agranulocytosis: monitor CBC/instruct on infection.

39
Q

What does Methimazole (Tapazole) and PTU alter?

A

Warfarin and Digoxin

40
Q

Should you take Methimazole (Tapazole) with food?

A

DO NOT TAKE WITH FOOD

41
Q

What should you monitor for when taking Methimazole (Tapazole) and PTU?

A

Worsening Hyperthyroidism or developing hypothyroidism

42
Q

Should you take food with PTU?

A

Administer at the same time each day in relation to meals- may need to take with meals to prevent stomach upset

43
Q

What does Radioactive Iodine do ?

A

Destroys thyroid producing cells

44
Q

When is radioactive iodine used ?

A

It is the last resort or before removal of thyroid.

45
Q

Why is radioactive iodine used?

A

For hyperthyroidism and thyroid cancer and thyroid function studies

46
Q

What are the adverse/side effects of radiation iodine?

A

~Radiation Sickness
* Hematemesis, epistaxis, intense nausea, vomiting
* Bone Marrow Depression
* Monitor CBC, WBC, platelets
* Hypothyroidism

47
Q

What are the nurse notes for Radiation Iodine ?

A
  • Encourage fluid intake (2-3 L/day)
  • Encourage frequent voiding
  • Instruct clients to dispose of body wastes properly - THIS IS RADIOACTIVE!
  • Instruct clients to avoid coughing and expectoration – Also radioactive!
48
Q

What is the timeline for women wanting to get pregnant while taking radioactive iodine?

A

Avoid pregnancy = 6 months to 1 year.

49
Q

What precautions should you take after Post radioactive iodine ?

A

~Use private toilets=flush twice
~Bathe daily, wash hands
~Avoid cough
~Do not sleep with other people
~DO laundry separate
~Do not prepare food for others

50
Q

Post-op for thyroidectomy ?

A

Place in Semi-fowlers position
Support head with pillows and sandbags
monitor bleeding

51
Q

Ensure to check for what after thyroidectomy ?

A

Bleeding under the patient, on the pillow or blue sheet.

52
Q

What should you monitor after thyroidectomy ?

A

Parathyroid damage

53
Q

What are the signs and symptoms of parathyroid damage?

A

hypocalcemia: numbness and tingling around mouth, muscle twitching, positive chvostek sign, positive trousseau sign

Pharmacology exam 3 (5 decks)

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