Thyroid Disorders Flashcards
T3 and T4 action
Increased metabolism
Increased HR and RR
Increased in glucose intake into cells > decreased blood glucose
Calcitonin
Secreted to decrease Ca+ levels in blood
Parathyroid Hormone
Stimulates Ca+ to go from the bones to the blood
Stimulated renal absorption of Ca+
If a pt. has parathyroid removed what are they are risk for?
Hypocalcemia
Hypothalamus releases:
Thyroid Releasing Hormone
Pituitary gland releases:
Thyroid Stimulated hormone
Eeyore is which exemplar?
HYPOthyroidism
Very slow, sluggish
Tigger is which exemplar?
HYPERthyroidism
Fast, tall and skinny
Hashimoto’s Thyroiditis
Autoimmune disease that causes hypothyroidism
Iodine deficit causes:
Hypothyroidism
Which med can cause hypothyroidism?
Lithium
What is lithium a Tx for relating to thyroid?
Hyperthyroidism
Manifestations of Hypothyroidism
Fatigue Weight gain Increased sleep Deceased appetite Susceptibility to cold temp Decreased HR, RR Decreased cardiac contractibility Decreased GI motility Hair loss
Myxedema
fluid collection associated with generalized non-pitting edema
Lab want to monitor with hypothyroidism
T3 - low
T4 - low
TSH - elevated in primary
Tx for hypothryoidism
Levothyroxine
Levothyroxine
Take in AM on empty stomach
Use caution w/ cardiovascular pt.
Must take lifelong
Thyroid levels need to be monitored when med adjusted
Myxedema Coma Signs and Sypmtoms
EXTREME HYPOTHRYOIDISM
Hypoxia CO2 retention - Resp. acidosis Hypoventilation Low HR F and E imbalances Hypothermia Hypoglycemia Hyponatremia - b/c excess fluid
Myxedema Coma Assess
Hyponatremia
Hypoglycemia
Prolonged QT interval
Cool extremities
Tx for hyponatremia
Water restriction
Spironolactone
Oral Na+ supplement
Pt. with Myxedema Coma is prescribed opioid for pain. What should the nurse do?
Myxedema Coma pt. are extremely sensitive to sedatives, analgesic, and anesthetics b/c slow metabolism - question prescription
Myxedema coma is a severe complication of what disorder?
Hypothyroidism
Tx for Myxedema Coma
IV levothyroxine Support airway Tx hyponatremia Tx bradycaria - Atropine Warming blankets Fluid management
Grave’s disease
Autoimmune disease that causes Hyperthyroidism
Manifestation of Hyperthyroidism
Exothalamos Incresed HR - dysrhythmias Heat intolerance Fatigue Nervousness Insomnia Weight loss Increased appetite Hair loss
Lab data for hyperthyroidism
T3 - elevated
T4 - elevated
TSH - decreased (primary) increased (secondary)
Goiter is caused by what hormone?
Increased TSH
Meds for Hyperthyroidism
Beta-blockers - control HR
Anti-Thyroid agents - Methimazole and Lithium carbonate
Glucocorticoids
Iodine
Possible Surgical complications for Hyperthyroidism
Airway compromise
Hemorrhage
Hypocalcemia
Damage to lyngeal nerve
Iodine-Potassium Tx
Decrease production of thyroid hormone and decrease blood flow to thyroid gland
Surgical management for Hyperthyroidism
Thyroidectomy
Could potentially remove parathyroid
Signs of Hypocalcemia
Trousseau and Chvostek's Sign Excitability of nerves and muscles Muscle spasms Dysphagia Wheezing Bronchospasms
Tx for Hypocalemia
IV calcium gluconate
Oral supplements
Signs the pt. is have a throat hemorrhage after thyroidectomy?
Repeated swallowing when not drinking or eating anything
Tx for hemorrhage or airway compromise after thyroidectomy
Trach tray at bedside
Suction setup
Complication of Hyperthyroidism:
Thyroid Storm
Manifestation of Thyroid Storm
EXTREME HYPERTHYROIDISM
Tachycardia Fever High Systolic HTN Abd pain LOC changed
Tx for Thyroid Storm
Glucocorticoids
Airway management and IV fluids **
Beta-blockers
Cooling blankets
What are the nurse’s priorities when a pt. is having a thyroid storm?
Airway Management
IV fluid resuscitation
Why give a pt. with a thyroid storm glucocorticoids?
Glucocorticoids decreased conversion of T4 to T3
Decreases TSH
What should the nurse monitor for in a pt. with thyroid storm?
Cardiac probs
Seizures - seizure precautions
Respiratory complications
