Thyroid: 5 Questions

Question 1

If the thyroid is under active?

Answer 1

TSH is High

Question 2

If the thyroid is over active ?

Answer 2

TSH is Low

Question 3

T3 and T4 are Low and TSH is High?

Answer 3

Hypothyroidism

Question 4

T3 and T4 are high and TSH is Low?

Answer 4

Hyperthyroidism

Question 5

What are the effects on the body of Hypothyroidism ?

Answer 5

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

Question 6

What is Goiter?

Answer 6

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

Question 7

What is the disease associated with Hypothyroidism?

Answer 7

Myxedema Coma/Crisis

Question 8

What is Myxedema Coma?

Answer 8

A severe life threatening complication of untreated hypothyroidism.

Question 9

Who is more commonly affected by Myxedema Coma?

Answer 9

Patients over 50 and in women

Question 10

What time of year is Myxedema Coma increased ?

Answer 10

Winter due to extreme temperatures.

Question 11

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

Answer 11

Loss of brain function or death can occur.

Question 12

What are the S/S of Myxedema Coma?

Answer 12

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

Question 13

What is the medication for Hypothyroidism ?

Answer 13

Levothyroxine (Synthroid)

Question 14

How should Levothyroxine (Synthroid) be administered?

Answer 14

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

Question 15

Is there a cure for Hypothyroidism ?

Answer 15

No, will have to remain on drugs.

Question 16

What does Levothyroxine (Synthroid) mimic?

Answer 16

T4 (Thyroxine)

Question 17

What is the dosage for Levothyroxine (Synthroid)?

Answer 17

25-200 mcg/day, anything over is questioned

Question 18

Is Levothyroxine (Synthroid) safe for pregnancy ?

Answer 18

Yes

Question 19

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

Answer 19

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

Question 20

What are the adverse effects to Hyperthyroidism?

Answer 20

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

Question 21

Should someone take thyroid meds for weight loss?

Answer 21

NO

Question 22

What interactions does thyroid medications have with other medications?

Answer 22

May enhance anticoagulants=thin the blood more.

Question 23

What happens when someone takes too much thyroid medication?

Answer 23

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

Question 24

What is exophthalmos?

Answer 24

Bulging eye=indicates long term hyperthyroidism.

Question 25

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

Answer 25

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

Question 26

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

Answer 26

Menstral Cycles get messed up.

Question 27

What is Thyroid Storm?

Answer 27

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

Question 28

How should a Nurse handle a patient with Thyroid Storm?

Answer 28

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

Question 29

What are the cardinal symptoms of thyroid storm?

Answer 29

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

Question 30

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

Answer 30

Build up in the lungs, crackles.

Question 31

What things could trigger thyroid storm ?

Answer 31

* Trauma, burns * Surgeries * Stroke * Acute brain injury * Others

Question 32

How do you treat Thyroid Storm?

Answer 32

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

Question 33

What is the goal for treating Hyperthyroidism ?

Answer 33

Eliminating excess thyroid hormone

Question 34

What things can help treat Hyperthyroidism?

Answer 34

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

Question 35

What is the MOA of Methimazole (Tapazole)?

Answer 35

Impede the formation of thyroid hormone.

Question 36

What is the reason to take Methimazole (Tapazole)?

Answer 36

Lower thyroid levels and Lower/normalize metabolic rate.

Question 37

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

Answer 37

Thyroidectomy or radioactive iodine therapy

Question 38

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

Answer 38

Agranulocytosis: monitor CBC/instruct on infection.

Question 39

What does Methimazole (Tapazole) and PTU alter?

Answer 39

Warfarin and Digoxin

Question 40

Should you take Methimazole (Tapazole) with food?

Answer 40

DO NOT TAKE WITH FOOD

Question 41

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

Answer 41

Worsening Hyperthyroidism or developing hypothyroidism

Question 42

Should you take food with PTU?

Answer 42

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

Question 43

What does Radioactive Iodine do ?

Answer 43

Destroys thyroid producing cells

Question 44

When is radioactive iodine used ?

Answer 44

It is the last resort or before removal of thyroid.

Question 45

Why is radioactive iodine used?

Answer 45

For hyperthyroidism and thyroid cancer and thyroid function studies

Question 46

What are the adverse/side effects of radiation iodine?

Answer 46

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

Question 47

What are the nurse notes for Radiation Iodine ?

Answer 47

* 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!

Question 48

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

Answer 48

Avoid pregnancy = 6 months to 1 year.

Question 49

What precautions should you take after Post radioactive iodine ?

Answer 49

~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

Question 50

Post-op for thyroidectomy ?

Answer 50

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

Question 51

Ensure to check for what after thyroidectomy ?

Answer 51

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

Question 52

What should you monitor after thyroidectomy ?

Answer 52

Parathyroid damage

Question 53

What are the signs and symptoms of parathyroid damage?

Answer 53

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