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NEC 3 > THYROID DISORDERS > Flashcards

THYROID DISORDERS Flashcards

1
Q

what is hyperthyroidism?

A

-hyperactivity of the thyroid gland
- a form of thyrotoxicosis and both usually occur together.

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2
Q

what is thyrotoxicosis

A

inappropriately high tissue thyroid levels of t4, t3, or both

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3
Q

what is grave’s disease?

A

-an autoimmune disease of unknown etiology
-marked by diffuse thyroid enlargement and excessive thyroid hormone secretion

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4
Q

marked by diffuse thyroid enlargement and excessive thyroid hormone secretion

A

Grave’s Disease

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5
Q

most common type of hyperthyroidism

A

Grave’s disease

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6
Q

grave’s disease more common in what gender?

A

more common in women aging 20 to 40 years

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7
Q

etiology of hyperthyroidism

A

-insufficient iodine supply
- infections
- smoking
- stressful life events
-abnormally high antibodies

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8
Q

abnormally high antibodies cause

A

creating false signals to the TSH receptors, increasing T3 & T4 release

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9
Q

clinical manifestations of hyperthyroidism

A

-palpable thyroid gland (goiter)
- bruits heard on the thyroid gland due to increased blood supply
-exopthalmos
-excessive sweating
- heat intolerance
- tachycardia
- tremors

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10
Q

What is the complication of hyperthyroidism?

A

Thyrotoxic crisis

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11
Q

What is thyrotoxic crisis?

A

-aka as thyroid storm
- an intensification of all hyperthyroid manifestations
- a rare yet-life threatening condition

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12
Q

Thyrotoxic crisis can happen to:

A

happens to patients with pre-existing hyperthyroidism, severe tachycardia, heart failure, shock, seizures, delirium

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13
Q

Diagnosis of hyperthyroidism

A

-Thyroid stimulating hormone test
- T4 test
- Radioactive Iodine Uptake Test

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14
Q

The purpose of thyroid-stimulating hormone test

A

-decreased TSH levels in positive patient
- an early warning system

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15
Q

T4 test role

A

-the main form of thyroid hormone
- more accurate when checked with TSH

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16
Q

Radioactive Iodine Uptake Test role

A

differentiate grave’s disease from other forms of thyroiditis

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17
Q

What are the antithyroid medications?

A
  1. thionamides
  2. iodine
  3. beta-adrenergic blockers
  4. propanolol (inderal)
  5. atenolol
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18
Q

the first-line antithyroid medication

A

thionamides

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19
Q

mechanism of action of thionamides

A

inhibit the synthesis of thyroid hormones

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20
Q

this drug is continued for 6 months to 2 years

A

thionamides

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21
Q

examples of thionamide drug

A
  • propylthiouracil
  • carbimazole
  • methimazole
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22
Q

iodine drug role in hyperthyroidism

A

-used with other antithyroid medications for thyroidectomy

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23
Q

iodine mechanism of action

A

rapidly inhibits synthesis of T3 and T4 and blocks the release of these hormones

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24
Q

through the use of iodine the surgery makes it much safer, why?

A

decreases the vascularity of the thyroid gland which makes surgery safer

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25
Q

Iodine example drug

A

-lugol’s solution
- potassium iodide (KI)
- tablets
- saturated solution of potassium iodide (SSKI)

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26
Q

Role of beta-adrenergic blockers in antithyroid medications

A

used for symptomatic relief of thyrotoxicosis

27
Q

role of propanolol in antithyroid medications

A

administered with other antithyroid agents and rapidly provides symptomatic relief

28
Q

role of atenolol in antithyroid medications

A

preferred for use in hyperthyroid patients with asthma or heart disease

29
Q

What is radioactive iodine therapy?

A

damages or destroys thyroid tissue, thus limiting thyroid hormone secretion

30
Q

radioactive iodine therapy can cause

A

causes dryness and irritation of the mouth and throat

31
Q

best for nonpregnant adults

A

radioactive iodine therapy

32
Q

interventions to prevent dryness and irritation of the mouth and throat when using a radioactive iodine therapy

A

-take sips of water or ice chips or baking soda solution (10 ml of baking soda in 250 ml water)

33
Q

surgical therapy for hyperthyroidism

A

thyroidectomy

34
Q

preferred surgical procedure

A

subtotal thyroidectomy

35
Q

removal of a significant portion (90%) of the thyroid gland

A

subtotal thyroidectomy

36
Q

what is subtotal thyroidectomy?

A

-preferred surgical procedure
- removal of a significant portion (90%) of the thyroid gland

37
Q

minimally invasive procedure with less scarring, less pain, and a faster return to normal activity

A

Endoscopic thyroidectomy

38
Q

what is endoscopic thyroidectomy?

A

minimally invasive procedure with less scarring, less pain, and a faster return to normal activity

39
Q

nutritional therapy for hyperthyroidism

A

-increased metabolic rate means more nutritional deficits
- high calorie diet (4,000 to 5,000 kcal/day) may be ordered
- avoid seasoning as it stimulate the already hyperactive GI tract
- coffee must be substituted to avoid restlessness and sleep disturbances

40
Q

nursing management for hyperthyroidism patient who have exophthalmos

A

for exophthalmos, apply artificial tears to soothe and moisten conjunctival membranes

41
Q

symptoms of iodine toxicity

A

-swelling of buccal mucosa
- excessive salivation
- nausea and vomiting
- skin reactions

41
Q

what is laryngeal stridor?

A

harsh, vibratory sound due to edema of the laryngeal nerve

42
Q

harsh, vibratory sound due to edema of the laryngeal nerve

A

laryngeal stridor

43
Q

what is hypothyroidism?

A

aka underactive thyroid (unable to produce enough of the thyroid hormones)

43
Q

what does overt primary hypothyroidism mean?

A

characterized biochemically by high serum levels of TSH and insufficient free circulating thyroid t4 hormone

44
Q

what does subclinical hypothyroidism means?

A

characterized by a high serum TSH and a normal serum level of free circulating t4 hormone

45
Q

dubbed as the “stove” of the body

A

thyroid gland

46
Q

“Puts the body “on fire”

A

thyroid gland

47
Q

the role of thyroid gland

A

-increases basal metabolic rate
-releases thyroid hormones

48
Q

What is thyroxine (t4)?

A

-main hormone
-the most abundant

49
Q

what is triiodothyronine (t3)?

A

the most active

50
Q

Etiology of Hypothyroidism

A
  1. Primary Hypothyroidism
  2. Secondary Hypothyroidism
  3. Tertiary Hypothyroidism
51
Q

What is primary hypothyroidism?

A

problems stem from the thyroid gland itself

52
Q

What is secondary hypothyroidism?

A

problems with the anterior pituitary gland

53
Q

What is tertiary hypothyroidism?

A

problem with hypothalamus

54
Q

what’s the common cause of hypothyroidism?

A

iodine deficiency

55
Q

what is iodine?

A

a mineral found in food which helps make thyroid hormone

56
Q

what is the atrophy of thyroid gland?

A

-due to hashimoto’s thyroiditis and grave’s disease (destroys thyroid gland)

57
Q

Radioactive Iodine Therapy (for Hypothyroidism)

A

-can occur anytime from one month after the treatment
- most common within the first 12 months after treatment

58
Q

clinical manifestations of hypothyroidism

A

-insidious and non-specific slowing of body processes
- symptoms may be unnoticed
-fatigued and lethargic
-impaired memory
-slowed speech

59
Q

diagnostic studies of hypothyroidism

A
  1. history and physical examination
  2. serum T3 and serum t4 levels (if ordered)
  3. Serum TSH and free t4 levels
  4. TRH stimulation test
  5. Thyroid peroxidase antibodies
60
Q

levothyroxine

A
  • drug of choice for hypothyroidism
  • dose is increased at 4 to 6 weeks intervals
    -lifelong therapy is required
60
Q

what’s the drug of choice of hypothyroidism

A

Levothyroxine

61
Q

Nursing management for hypothyroidism

A

-Monitor pulse rate greater than 100 beats/minute on irregular heartbeat must be reported
- watch out for chest pain, weight loss, nervousness, tremors or insomnia
- Serum TSH levels must be checked 4 to 6 weeks after changing levothyroxine preparation.

NEC 3 (16 decks)

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