Thyroid Flashcards
What 3 hormones are produced by thyroid gland?
T3
T4
Calcitonin
What does calcitonin do?
Decreases serum calcium levels by taking calcium out of the blood and pushing it back into the bone
What do you need to make hormones?
Dietary iodine
Thyroid hormone gives us ___
Energy
Hyperthyroid = ?
Too much energy!—Graves Disease!!
Hyperthyroid
Outlook
Nervous
Irritable
Attention span decreased
Hyperthyroid
How is appetite?
Weight?
Appetite increases
Weight decreases
Hyperthyroid
Body temp
Hot and sweaty
Hyperthyroid
Eyes
Exophthalmos
Hyperthyroid
GI
Increases
Hyperthyroid
BP and HR
Increases
*can have arrhythmias/palpitations
Hyperthyroid
Thyroid size
Increase
Hyperthyroid
Diagnosis…T4? TSH?
T4= Increased TSH= Decreased
Hyperthyroid
Dx test and teaching
Thyroid scan
No iodine med 1 week before scan and must wait 6 weeks to restart them
Hyperthyroid
Other dx?
US
MRI
CT
Hyperthyroid
Ex of a drug that has a lot of iodine levels?
Amiodarone (DOC for v-fib and v-tach)
Hyperthyroid
Examples of anti-thyroids?
Methimazole
Propylthiouracil
Hyperthyroid
What do anti-thyroids do?
Stop thyroid from making thyroid hormones
Hyperthyroid
Anti-thyroids used ___ to stun thyroid
Preop
Hyperthyroid
Anti-thyroids…we want client to become ____
Euthyroid
Hyperthyroid
Example of iodine compounds?
Potassium iodine
Hyperthyroid
What do iodine compounds do?
Decrease size and vascularity of the gland
Hyperthyroid
ALL endocrine glands are very ___
Vascular (this is why its good to give iodine compounds for hyperthyroid—since iodine compounds decrease size and vascularity of gland)
Hyperthyroid
How to give iodine compounds?
Mild or juice, WITH A STRAW (can stain teeth)
Hyperthyroid
Why give BB?
Supportive therapy (propanolol)
- Decrease myocardial contractility, CO, HR, BP
- Situational anxiety
Hyperthyroid
Do not give BB to who?
Asthmatics
Diabetics
Hyperthyroid
Radioactive iodine therapy is given in how many doses?
One
Hyperthyroid
How to give radioactive iodine therapy?
PO (liquid or tab)
Hyperthyroid
Rule out what before giving radioactive iodine therapy?
Pregnancy
Hyperthyroid
What does radioactive iodine therapy do?
Destroys thyroid cells (so you become hypothyroid)!
Hyperthyroid
Radioactive precautions need to be followed for radioactive iodine therapy. Ex?
Stay away from babies for 1 week
Dont kiss anyone for 1 week
Hyperthyroid
Watch for what during tx with radioactive iodine?
THYROID STORM! (if all thyroid cells aren’t destroyed then a little bit that is left will overwork and that can cause a storm)
Hyperthyroid
Surgery?
Thyroidectomy (partial or complete)
Hyperthyroid-Thyroidectomy
Post op priority?
Hemorrhage
Hyperthyroid-Thyroidectomy
Report what feelings?
Pressure
Hyperthyroid-Thyroidectomy
Check for bleeding where?
Incision site, behind neck
Hyperthyroid-Thyroidectomy
Assess for what?
Recurrent laryngeal nerve damage by listening for hoarseness
Hyperthyroid-Thyroidectomy
Could lead to what?
Vocal cord paralysis
Hyperthyroid-Thyroidectomy
When there is paralysis of both cords, what will require immediate trach?
Airway obstruction
Hyperthyroid-Thyroidectomy
Keep what at bedside?
Trach set
Hyperthyroid-Thyroidectomy
Why would we need a trach? (3)
- Swelling
- Recurrent laryngeal nerve damage
- Hypocalcemia
Hyperthyroid-Thyroidectomy
Why would pt. have hypocalcemia?
PTH may have been removed
Hyperthyroid-Thyroidectomy
S/s of hypocalcemia?
Rigid, tight muscles
NOT sedated
Hyperthyroid-Thyroidectomy
Teach what?
How to support neck
Hyperthyroid-Thyroidectomy
Keep what close?
Personal items
Hyperthyroid-Thyroidectomy
HOB?
Elevated
Hyperthyroid-Thyroidectomy
Nutrition?
Client needs more calories
HYPOthyroid
Energy or no?
No energy–Fatigue!
HYPOthyroid
Expression? Speech?
No expression
Speech slurred and slow
HYPOthyroid
Weight?
GI?
Weight increase
GI decrease
HYPOthyroid
Hot or cold
Cold
HYPOthyroid
Period?
Amenorrhea
HYPOthyroid
You may be taking care of totally ___ client
Immobile
HYPOthyroid
DX–T4? TSH?
T4: Decrease
TSH: Increase
HYPOthyroid
Tx?
Levothyroxine
HYPOthyroid
Teaching about levothyroxine or liothyronine?
- Take on empty stomach
- On med forever
- Energy level will increase with these drugs
HYPOthyroid
People with hypothyroidism tend to have _____
Increase BP/CAD!!!
*worried about CV strain when you start these drugs
HYPOthyroid
What are you worried about when starting levothyroxine or liothyronine?
MI!!!
Many ppl with hypothyroidism also have CAD or increase BP…. so when starting these drugs, worried about too much strain that could lead to MI
