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210 exam 2 > thyroid disorders > Flashcards

thyroid disorders Flashcards

1
Q

what are the disorders of the thyroid gland

A

hyperthroidism
thyroid englargement (goiter)
hypothyroidism

thyroiditis

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2
Q

what is thyroiditis

A

inflammation of the thyroid gland from stress on body can resolve on its own and could cause hypothyroidism

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3
Q

what is hyperthyroidism

A

is a clinical syndrom in which there is sustained increase in synthesis and release of thyroid hormones by the thyroid gland

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4
Q

what is the percent it occurs in men and women

A

.2% in men

2% in women

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5
Q

what is thyrotoxicosis

A

physiological effects of hyper metabolism that results from excess levels of T4, T3 and free T4

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6
Q

what is the highest frequency in which hyperthyroidism usually occurs

A

20-40 years of age

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7
Q

what is the most common form of hyperthyroidism

A

graves diseases 80%

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8
Q

what are other causes of hyperthyroidism

A 
toxic nodular goiter
thyroiditis
exogenous iodine excess
pitituary tumor
thyroid cancer
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9
Q

what are the normal levels of TSH, T4, Free T4 and T3`

A

TSH 0.4-4.9 mU/L
T3 80-180 ng/dL
T4 5-13.5 mcg/dL
Free T4 0.7-2 ng/dL

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10
Q

what will the levels be like in hyperthyroidism

A

TSH will be low

T3, T4, and Free T4 will be high

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11
Q

what is graves disease

A

autoimmune disorder of unknown etiology

  • thyroid englargment
  • excess thyroid hormone production
  • precipitating factors and genetic factors (infections, stressful life event, smoking)
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12
Q

Graves disease accounts for ______% of cases of hyperthyroidism

A

75-80

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13
Q

what happens in graves disease with the hormone levels

A

patient develops antibodies to the TSH receptor
antibodies attach to receptors and stimulate thyroid to release T3, T4 or both
hormones causes clinical manifestation

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14
Q

what can happen with progress of graves disease

A

destruction of thyroid leading to hypothyroidism

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15
Q

what are clinical manifestation of hyperthyroidism

A

-direct effect of hormones on increasing metabolism
-increased tissues sensitivity to stimulations by the sympathetic nervous system
-goiter
-ophthalmopathy (exophthalmos) - protruding eyeballss
due to the impaired drainage from the orbit, which causes increased fat deposits and fluid in the retroorbital tissues

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16
Q

Ophthalmopathy occurs in ___% of patients with graves disease

A

20-40

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17
Q

what is a complication of hyperthyroidism

A

thryotoxic crisis (thyroid storm)

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18
Q

what is thyrotoxic crisis

A

life threatening emergency through to result from stressors such as infection, trauma or surgery

19
Q

what are manifestations of thyrotoxic crisis

A 
severe tachycardia
heart failure
shock
hyperthermia
seizures
delirium
coma
20
Q

what is the treatment of thyrotoxic crisis

A

immediate to prevent death
aimed at reducing thyroid hormone levels, managing respiratory distress, fever reduction, fluid replacement and elimination or management of stressors

21
Q

what are diagnostic studies of hyperthyroidism

A

decreased TSH levels
elevated FT4, T4 T3
radioactive iodine uptake (RAIU) helps determine if graves disease of other process is going on

22
Q

what is the goal of hyperthyroidism

A

block adverse effects of excessive thyroid hormone, suppress over secretion of thyroid hormones and prevent complications

23
Q

what inter professional care of hyperthyroidism

A

antithyroid meds
radioactive iodine therapy
subtotal thyroidectomy - about 90% of thyroid is removed

24
Q

what are antithyroid drugs

A

inhibit the synthesis of thyroid hormones takes several weeks

  • prophylthiouracil (PTU)
  • methimazole (tapzaole))
25
Q

what are drug therapy options

A

antithyroid drugs
iodine- rapidly inhibits synthesis of T3, T4 and blocks release into circulation
saturated solution of potassium and lug solution
B-adrenergic blockers- provides symptomatic relief
inderal

26
Q

what is radioactive iodine therapy

A

treatment of choice for most nonpregnant adults
destroys thyroid tissue
2-3 months for effects
high incidence of post treatment hypothyroidism

27
Q

when doing radioactive iodine therapy what shouldn’t you be around

A

pregnant, young children, older adults of immnocomprised because for 7-10 days your body is still releasing the radioactivity

28
Q

what should be taken prior to surgery

A

antithyroid drugs
iodine
B-adrengeric drugs: propanolo (inderal)

29
Q

what is a subtotal thyroidectomy

A

removal of 90% of thyroid gland

30
Q

what are indications that you could do a subtotal thyroidectomy

A

unresponsive to therapy
very large goiter
possible malignancy

31
Q

what is an advantage of subtotal thryoiectomy over RAI

A

rapid reduction of T3, and T4 levels

32
Q

what are nursing implementation of exophthalmos

A

artifical tear
salt restriciton
elevate head of bd
administer corticosteroids

33
Q

what are nursing implementation of thyroid surgery

A

prepare room with O2 suction and tracheotomy tray\
monitor repsirations
observe for tetany

34
Q

what are post op complications with hyperthyroidism

A 
hypothyroidism
damage to, or inadvertent removal of parathyroid gland
hermorrhage
thyrotoxic crisis
infection
35
Q

what is hypothyroidism

A

results from insufficient circulating thyroid hormone

36
Q

what is primary hypothyroidism

A

related to destruction of thyroid tissue or defective hormone synthesis

37
Q

what is secondary hypothyroidism

A

releated to pitutuaty disease with decreased TSH secretion of hypothalamic dysfunction with decreased thyropin releasing hormone secretion

38
Q

what is the most common cause of hypothyroirism worldwide

A

iodine deficiency

39
Q

what are clinical manifestation of hypothyroidism

A
  • insidious and nonspecific slowing of body processes
  • impaired memory, slowed speech, depressed, fatigues, lethargic
  • decrease CO and cardiac contractitility
  • low excercise tolerance and SOB on exertion
  • anemia
  • coronary atherosclerosis
  • constipation
  • cold intolerance
  • dry, course skin, brittle nails
  • muscle weakness, and swelling
  • weigh gain
  • myxedem
40
Q

what is myxedema

A

accumulation of hydrophilic mucopolysaccharides in dermis and other tissues causing characteristic facies of hypothyroidism

41
Q

what are complications of hypothyroidism

A

mental sluggishness, drowsiness pay progress to impairment of consciousness and coma

myxedema coma

42
Q

what is myxedema coma

A

emergency due to infection, drugs, exposure to cold and trauma

  • subnormal temperature
  • hypotension
  • hypoventiliation

treatment: IV thyroid hormone replacment

43
Q

what are the diagnositic studies of hypothyroidism

A

High TSH, low T3, T4 and FT4

44
Q

what is the goal of hypothyroidism

A

resture euthyroid state with hormone replacement therapy
-low calorie diet
levothyroxine (synthroid) – same time before meal on empty stomach

DO NOT give iron pill with 4 hours of levothryoxine

210 exam 2 (9 decks)

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