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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
Iodine example drug
-lugol's solution - potassium iodide (KI) - tablets - saturated solution of potassium iodide (SSKI)
26
Role of beta-adrenergic blockers in antithyroid medications
used for symptomatic relief of thyrotoxicosis
27
role of propanolol in antithyroid medications
administered with other antithyroid agents and rapidly provides symptomatic relief
28
role of atenolol in antithyroid medications
preferred for use in hyperthyroid patients with asthma or heart disease
29
What is radioactive iodine therapy?
damages or destroys thyroid tissue, thus limiting thyroid hormone secretion
30
radioactive iodine therapy can cause
causes dryness and irritation of the mouth and throat
31
best for nonpregnant adults
radioactive iodine therapy
32
interventions to prevent dryness and irritation of the mouth and throat when using a radioactive iodine therapy
-take sips of water or ice chips or baking soda solution (10 ml of baking soda in 250 ml water)
33
surgical therapy for hyperthyroidism
thyroidectomy
34
preferred surgical procedure
subtotal thyroidectomy
35
removal of a significant portion (90%) of the thyroid gland
subtotal thyroidectomy
36
what is subtotal thyroidectomy?
-preferred surgical procedure - removal of a significant portion (90%) of the thyroid gland
37
minimally invasive procedure with less scarring, less pain, and a faster return to normal activity
Endoscopic thyroidectomy
38
what is endoscopic thyroidectomy?
minimally invasive procedure with less scarring, less pain, and a faster return to normal activity
39
nutritional therapy for hyperthyroidism
-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
nursing management for hyperthyroidism patient who have exophthalmos
for exophthalmos, apply artificial tears to soothe and moisten conjunctival membranes
41
symptoms of iodine toxicity
-swelling of buccal mucosa - excessive salivation - nausea and vomiting - skin reactions
41
what is laryngeal stridor?
harsh, vibratory sound due to edema of the laryngeal nerve
42
harsh, vibratory sound due to edema of the laryngeal nerve
laryngeal stridor
43
what is hypothyroidism?
aka underactive thyroid (unable to produce enough of the thyroid hormones)
43
what does overt primary hypothyroidism mean?
characterized biochemically by high serum levels of TSH and insufficient free circulating thyroid t4 hormone
44
what does subclinical hypothyroidism means?
characterized by a high serum TSH and a normal serum level of free circulating t4 hormone
45
dubbed as the "stove" of the body
thyroid gland
46
"Puts the body "on fire"
thyroid gland
47
the role of thyroid gland
-increases basal metabolic rate -releases thyroid hormones
48
What is thyroxine (t4)?
-main hormone -the most abundant
49
what is triiodothyronine (t3)?
the most active
50
Etiology of Hypothyroidism
1. Primary Hypothyroidism 2. Secondary Hypothyroidism 3. Tertiary Hypothyroidism
51
What is primary hypothyroidism?
problems stem from the thyroid gland itself
52
What is secondary hypothyroidism?
problems with the anterior pituitary gland
53
What is tertiary hypothyroidism?
problem with hypothalamus
54
what's the common cause of hypothyroidism?
iodine deficiency
55
what is iodine?
a mineral found in food which helps make thyroid hormone
56
what is the atrophy of thyroid gland?
-due to hashimoto's thyroiditis and grave's disease (destroys thyroid gland)
57
Radioactive Iodine Therapy (for Hypothyroidism)
-can occur anytime from one month after the treatment - most common within the first 12 months after treatment
58
clinical manifestations of hypothyroidism
-insidious and non-specific slowing of body processes - symptoms may be unnoticed -fatigued and lethargic -impaired memory -slowed speech
59
diagnostic studies of hypothyroidism
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
levothyroxine
- drug of choice for hypothyroidism - dose is increased at 4 to 6 weeks intervals -lifelong therapy is required
60
what's the drug of choice of hypothyroidism
Levothyroxine
61
Nursing management for hypothyroidism
-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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