Thyroid Disorders

Question 1

Name this disorder: Excessive sweating, fatigue, heat intolerance, increase and irregular BP/HR, anxiety, hand tremor, wt. loss, and enlarged thyroid?

Answer 1

Grave’s disease

Question 2

Name this disorder: Fatigue, wt. gain, dry/hair loss, depression, constipation, muscle weakness, puffy eyes, decrease HR, and swelling of extremities?

Answer 2

Hashimotos thyroiditis

Question 3

What is an immune disorder of the thyroid?

Answer 3

Grave’s disease

Question 4

What is it called when the immune system attacks thyroid?

Answer 4

Hashimotos thyroiditis

Question 5

What is the condition where the thyroid gland is overactive and produces too much of the hormone thyroxine?

Answer 5

Hyperthyroidism

Question 6

What is the condition where the thyroid gland is underactive and doesn’t produce enough thyroid hormone?

Answer 6

Hypothyroidism

Question 7

Name this disorder: intolerance to cold, receding hairline, facial/eyelid edema, dull-blank expression, extreme fatigue, thick tongue, slow speech, anorexia, brittle hair/nails, menstrual disturbances, constipation, muscle aches/weakness, dry skin (coarse/scaly), lethargy, goiter, fluid retention, depression, parasthesia, wt. gain, low HR, high choles., low Na, apathy and hair loss?

Answer 7

Hypothyroidism

Question 8

What lab values are decreased in hypothyroidism?

Answer 8

Serum T4/3 and T3 uptake

Question 9

What lab values are increased in hypothyroidism?

Answer 9

Serum TSH

Question 10

What lab values are decreased in hyperthyroidism?

Answer 10

Serum TSH

Question 11

What lab values are increased in hyperthyroidism?

Answer 11

Serum TA, Serum T3/4, T3 uptake and thyroid suppression

Question 12

Name this disorder: heat intolerance, insomnia, palpations, diarrhea, increased peristalsis, increased appetite, wt. loss, goiter, fine/straight hair, bulging eyes, facial flushing, tachycardia, increased systolic BP, breast enlargement, muscle wasting, menstrual changes (amenorrhea), tremors, and finger clubbing?

Answer 12

Hyperthyroidism

Question 13

What is a goiter?

Answer 13

Abnormal enlargement of the thyroid gland

Question 14

Women, fam history of Grave’s disease, high iodine intake, and being 20-40y/o are risk factors for?

Answer 14

Hyperthyroidism

Question 15

What surgery is more common for hyperthyroidism?

Answer 15

Subtotal thyroidectomy

Question 16

What does BOWTIE stand for when considering post-op monitoring for thyroidectomy?

Answer 16

Bleeding
Open airway
Whisper
Trache set
Incision
Emergency

Question 17

What’s a big complication of hyperthyroidism?

Answer 17

Thyroid storm

Question 18

S/S of thyroid storm?

Answer 18

Fever, enlarged thyroid and wide pulse pressure

Question 19

What’s the treatment for a thyroid storm?

Answer 19

Cooling, Aspirin, replace F/E and reduce thyroid hormone synthesis

Question 20

What 2 drugs help w/ decreasing the thyroid hormone synthesis and are usually prescribed in high doses?

Answer 20

PTU and methimazole

Question 21

What 2 anti-thyroid meds are prescribed usually in combo tp help prevent thyroid gland from producing excess amounts of hormones?

Answer 21

Propylthiouracil (PTU) and methimazole (Tapazole)

Question 22

S/S usually begin working when while taking PTU and Methimazole?

Answer 22

6-12wks

Question 23

What severe damage does the use of PTU and Methimazole cause?

Answer 23

Liver damage/bone marrow toxicity

Question 24

Beta blockers are prescribed for what in pt’s w/ hyperthyroidism?

Answer 24

Treat high BP

Question 25

What med is given PO that is absorbed by the thyroid gland and causes the gland to shrink causing s/s to subside?

Answer 25

Radioactive iodine

Question 26

How long do symptoms usually subdue when taking Radioactive iodine?

Answer 26

3-6mon

Question 27

What can taking radioactive iodine cause?

Answer 27

Hypothyroidism

Question 28

Thyroid surgery, neck radiation, anti-thyroid meds, iodine deficiency, hashimotos thyroiditis, and being women are risk factors for what?

Answer 28

Hypothyroidism

Question 29

What is the most common cause of a goiter?

Answer 29

Hashimotos thyroiditis

Question 30

What meds are commonly used for hypothyroidism?

Answer 30

Synthetic thyroid hormone: levothyroxine (synthroid)

Question 31

Side effects of Synthroid?

Answer 31

Palpations, angina, HA, insomnia, nausea, diarrhea and HTN

Question 32

When should you take Synthroid?

Answer 32

30 min before breakfast on an empty stomach; don’t stop aburptly

Question 33

What is the most adverse effect of Synthroid?

Answer 33

Fatal cardiac dysrhythmia from OD

Question 34

Synthroid is contraindicated in what?

Answer 34

New MI, hyperthyroidism, adrenal insufficieny

Question 35

What is the most severe complication of hypothyroidism that is rare but may be caused by an infection, illness, exposure to cold, or certain meds?

Answer 35

Myxedema coma

Question 36

What are the cardinal manifestations of myxedema coma?

Answer 36

Deterioration of mental statues

Question 37

What is required in a pt w/ myxedema?

Answer 37

ICU for resp/cardiac support, IV thyroid and steroid drugs

Question 38

What are some nursing implications for radioactive iodine?

Answer 38

Sleep alone for 3-5 nights
Avoid personal contact w/ children for 3-7d
1st 3 days avoid close contact w/ people (6ft), public areas, drink plenty of water, don’t share items, do laundry/dished separate, wipe toilet seat after every use, wash hands frequently, shower daily

Question 39

Nursing considerations for levothyroxine Synthroid?

Answer 39

Take on empty stomach, 30 min before breakfast,
don’t stop abruptly, take @ same time daily
Decreases effects of antidiabetic meds
Enhances oral anti coagulation

Question 40

Nursing implications for PTU and Methimazole?

Answer 40

Take w/ meals, don’t stop abruptly,
Take @ same time everyday,
Iodized salt or shellfish can alter effectiveness