Thyroid Flashcards
What does T3T4 and TSH correlate ?
T3T4 correlate disease
TSH opposite disease
calcitonin fnx
serum ca to the bone
decr serum ca
iodine fnx in thyroid
used to make t3t4
turn food to energu
assessment of thyroid (3)
palpate- symmetry, tenderness
auscultate for buits
Serum TSH levels abnm
> 4 hypo thyroidsm
how often do TSH
q 5 years 35-39 y.o
what test confirm abnm TSH
FT4
What does serum thyroglobulin measure
its precurson to t3 n t4
radioactive iodine
whats given
how measured
results
rai 123
scintillation
hyperthyriod incr iodine intake
hypothyr decrease iodine intake
what is radioactive iodione also used for (not test)
radiate thyroid for hyperthyr
Whats meds should look at before radioactive iodine test 7
heart over counter diuertic
cough syrup ASA cimetidine furosemide hepatin lithim olols
What precautions for radioactive iodione (test incl)- 3
no sharing cups or utensils
no sexual contact/ no same bed
cautn children and pregn women
can be transfered saliva urine or radiation emitting from body
abnmties of thyroid fxn 3
creitism- stunted mental physical growth congenital or baby
goiter- enlarged thyroid rt iodine insuff.
euthyroid- normal
Hypothyroid
what disease assc
what thyroid levels
Hashmimotos- autoimmune thyroiditis
TSH elevated and low t4t3
hypothyroidism
how they look 7
face/head- 3
dry skin cold intoleranc e fluid retention swollen undereye thin hair masklike face fat (wt gain)- not hungry husky low vc slowed speech
HYPOthyroidism
how they feel 6
SOB very tired personality change hands bigger parasthesis- tingling not hungry
HYPOthyroidism
labs and vs 5
what 3 meds sensitive to
low everything
low BG, low NA, low P, BP,
increase CHO
sedatives, analgesics, opiods
Geriatric cons with HYPOthyr 5
signs and sympt
complicationa
vauge s/s- muscle aches mental confusion,
contipation
deathness can occur decre mobility
HYPOthyroid Treatment
Hormone replacement- name, dosage, goal, instructions
Levothyroxine (based on TSH lvl)
goal to subside s/s (TSH WNL)
take 30 mins before meals with WATER
HYPOthyroid hormone replacement side effects
meds (2) and vitals (3) and PC
Levothyroxine
palplation/ tachycardia/ incr BG
if angina call MD
decrease effect laoxin (digoxin)
increase effect anticoag
Supportive therapy for HYPOthyroid 6 resp, cold, pc, med
o2 BNC to lower RR no external heat- regular blanket (no elctl) IV synthroid (t3t4)- myexedema caution with fluids corticosteriods
HYpothyr caution for meds ?
no PO med if s/s too bad
Nursing mngt HYPOthyr 4
gradual return to activity
LOC check
meds are forever (dont skip
wt loss)
Hyperythroidism
which disease assc
what pop
thyroid levels
GRaves disease
females 8x more common
incr t3t4 low TSH
What disease heart commnly assc with HYPOthyr
CAD incr chol
Arteriosclerosis
what is throxicosis
over active thyroid
Hyperthyroidism
what they look like 5
pale fine hand tremors skinny (hungry) popeyed (exopthamlos) thyroid enlargemnt
Hyperthyroid
what they feel like 5
excited emotional apprhensice heat intolerance hungry warm
HYperthyroid
what labs/ vs- 4
2 diseases
osteoporosis
CHF
tachycardia - incr HR and P
incr SBP
increase iodine intake
bruit/ thrill -
Hyperthyroidism
radioactive
radioactive iodine(resolved in 3-4 wks)- may be single dose
Hyperthyroid tx
anti- thyroid 2 meds
antithyroid-takes weeks to resolve
propylthicuracil methimazole (MMI)- once euthyroid- maintenance dose established and tapered over months
Methimazole side effects- 5
side effects- fever, GI probl, urticarial (hives), agranulocytosis (loose blood risk infection) thrombocyopenia (no platelets incr bleeding)
Methimazole discontinue med and notfy md if (3)
PC
infection (esp pharygitis) mouth ulcers fever
PC - thyroid storm
Hyperthyroid
Iodides 4
potassium iodide
lugol’s soln
Beta Adrenergic blocking - OLOL
SSKI- saturated soln of pot iodide
Lugols soln complications
3
esophpgeal or duodenal injury (GI ulcer hematoma )
Betablockers meds 5 functions 6
propanolol, atenolol, metoprolol - decrease heart rate SBP, muscle weakness nervousnes and tremors , heat intolence
Remove all or part thyroid HYPERTHYROID
3 interventions
preop- antithyroid med until s/s disapered or betablocker decrease hr
stop any blood thinners weeks before
hyperthyroid diet 6 do’s and dont
avoid caffeine, tea, cola, alcohol
hi cal hi protein
Nursing intvn 2 vision and attn
short span - give ample time ]
vision- very dry eye eyedrops
Nodular Tumor s/s and txm
thyroid moves down and causes pressure
remove thyroid
Thyroids Cancer cause ss tx dx
external radiation
lesions hard and fix- cervial lymph
dx- needle bx
tx- surgical removal or radiation
radiation thyroid cancer
side effects 5
sore neck, nausea upset stomach dry mouth change in taste
All surgery Thyroid monitor and implamentn 7
montr back and side dressing for bleedig monitor respiratory feel for fullness incisions semifowlers pos intruct for to talk hi cal for wt gain monitor for tetany
