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CMPA412 > Thyroid Gland Disorders > Flashcards

Thyroid Gland Disorders Flashcards

1
Q

Thyroid gland secretes the following hormones

A

T3
T4
Thyrocalcitonin

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2
Q

T3 (Triidothyronine) Function

A

Metabolism and Growth

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3
Q

T4 (Thyroxine, tetraiodothyronine)

A

Catabolism and Body Heat Production

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4
Q

regulates serum Ca++ levels
bring down the blood Ca++ level

A

Thyrocalcitonin

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5
Q

Increase T3 = Increase metabolic rate
Increase T4 = Increase body heat production
Increase Thyrocalcitonin = Decrease calcium

A

Hyperthyroidism (Thyrotoxicosis)

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6
Q

Hyperthyroidism Cause: most common cause

A

Grave’s Disease

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7
Q

Hyperthyroidism Cause: autoimmune disorder due to the production of an antibody/immunoglobulin TSI (thyroid stimulating immunoglobulin) that has the same effect as TSH…this stimulates the body to produce high amounts of thyroid hormones (genetic)

A

Grave’s Disease

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8
Q

Hyperthyroidism Cause: not autoimmune…growths of nodular goiters that are independently functioning to cause hypersecretion of thyroid hormones

A

Toxic Nodular Goiter

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9
Q

Hyperthyroidism Cause: inflammation of the thyroid gland and this can cause T3 and T4 leak into the body

A

Thyroiditis

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10
Q

Hyperthyroidism Cause: Protruding eyeballs, goiter, pretibial myxedema: waxy orange peel appearance of the skin found in the feet and legs

A

Grave’s Disease

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11
Q

Hyperthyroidism Cause: won’t see ophthalmic signs like the protruding eye balls but the classic signs and symptoms of hyperthyroidism

A

Toxic Nodular Goiter

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12
Q

Hyperthyroidism CM: HR?, BP?

A

Tacycardia, Hypertension

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13
Q

Hyperthyroidism CM: ? Appetite, ? Loss

A

Voracious
Weight

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14
Q

Hyperthyroidism CM: Frequent ?, ? Intolerance

A

Sweating (Diaphoresis)
Heat

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15
Q

Hyperthyroidism CM: absence of ? in F, ? hair, ? nails

A

Menstruation (Amenorrhea)
Fine Silky
Pliable

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16
Q

Hyperthyroidism CM: Mood Changes?, Fine ?

A

Irritability, Restlessness, Nervousness
Tremors

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17
Q

Hyperthyroidism Interventions: Provide a ? and ? environment

A

Cool, Quiet

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18
Q

Hyperthyroidism Interventions: Provide adequate ? Administer ? as prescribed

A

Rest
Sedatives

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19
Q

Hyperthyroidism CM: Due to accumulation of fluids, mucopolysaccharides at the fat-pads behind the eyeballs, it can lead to corneal ulceration

A

Exopthalmos

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20
Q
A
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21
Q

Hyperthyroidism CM: Long and deep palpebral fissure is still evident when one looks down

A

Von Graefe’s Sign (Lid Lag)

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22
Q

Hyperthyroidism CM: Forehead remains smooth when one looks up

A

Jeffrey’s Sign

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23
Q

Hyperthyroidism CM: Bright-eyed stare, infrequent blinking

A

Dalyrimple’s Sign (Thyroid Sign)

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24
Q

Hyperthyroidism CM: Warm, flushed sweaty skin
Thickened hyper-pigmented skin at the pretibial area

A

Dermopathy

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25
Q

Hyperthyroidism Interventions: Diet ?

A

High Calorie and CHON
Vitamin and Mineral Supplements
Fluid Intake (If there’s diarrhea)

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26
Q

Hyperthyroidism Interventions: Avoid Stimulants like ?

A

Coffee, Tea, and Nicotine

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27
Q

Hyperthyroidism Interventions: Obtain ? daily

A

Weight (Same Time, Clothes, Weighing Scale)

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28
Q

Hyperthyroidism Interventions: Protect the eyes by ?

A

Using artificial tears at regular intervals
Wearing dark sunglasses
Taping eyelids at night (if necessary)

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29
Q

Hyperthyroidism Interventions: Prepare the client for ? therapy, → destroys thyroid cells

A

Radioactive Iodine

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30
Q

Hyperthyroidism Interventions: Prepare the client for ?if prescribed

A

Subtotal Thyroidectomy

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31
Q

Hyperthyroidism Pharmacotherapy: ß-blockers

A

Propanolol

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32
Q

Hyperthyroidism Pharmacotherapy: These drugs are given to control tachycardia and HPN

A

Ca+ Channel Blockers

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33
Q

Hyperthyroidism Pharmacotherapy: Are given to inhibit release of thyroid hormone

A

Iodides: Lugols Solution (SSKI Saturated Solution of Potassium Iodide)

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34
Q

Hyperthyroidism Pharmacotherapy: Iodides: Lugol’s solution shoul be mix with ? with ? or glass of water to improve its palatability

A

Fruit Juice
Ice

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35
Q

Hyperthyroidism Pharmacotherapy: Iodides: Lugol’s Solution - Provide drinking straw to prevent permanent ?

A

staining of teeth

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36
Q

Hyperthyroidism Pharmacotherapy: Iodides: Lugol’s Solution Side Effects?

A

Allergic Reaction, Increased Salivation, Colds

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37
Q

Hyperthyroidism Pharmacotherapy: These are given to inhibit synthesis of thyroid hormones

A

Thioamides

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38
Q

Hyperthyroidism Pharmacotherapy: Thioamides

A

PTU (Propylthiouracil)
Tapazole (Methimazole)

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39
Q

Hyperthyroidism Pharmacotherapy: Side effects of PTU

A

Agranulocytosis
Neutropenia

40
Q

Hyperthyroidism Pharmacotherapy: ? must be avoided because it can displace the T3/T4 from the albumin in the plasma causing increased manifestations

41
Q

Hyperthyroidism Pharmacotherapy: inhibit the action of thyroid hormones

A

Dexamethasone

42
Q

Hyperthyroidism Pharmacotherapy: NOT recommended in pregnant women because of
potential teratogenic effects. Pregnancy should be
delayed for ? months after therapy

A

Radiation Therapy (Iodine)
6 mos

43
Q

Hyperthyroidism Subtotal Thyroidectomy: Usually about ? of the gland is removed

44
Q

Hyperthyroidism Subtotal Thyroidectomy: Position

A

Semi-fowler’s with head, neck, shoulders erect

45
Q

Hyperthyroidism Subtotal Thyroidectomy: Prevent Hemorrhage

A

Ice collar over the neck

46
Q

Hyperthyroidism Subtotal Thyroidectomy: Keep ? set available for the first ? post-op

A

Tracheostomy
48 hrs

47
Q

Hyperthyroidism Subtotal Thyroidectomy: Ask the patient to ? (to assess for recurrent laryngeal nerve damage)

A

Speak every hour

48
Q

Hyperthyroidism Subtotal Thyroidectomy: Keep ? readily available – ? occurs if hypocalcemia is present. This may be secondary to the accidental removal of the parathyroid gland

A

Ca+ Gluconate
Tetany

49
Q

Hyperthyroidism Subtotal Thyroidectomy: Monitor Body Temperature - ? is an initial sign of thyroid crisis

A

Hyperthermia

50
Q

Hyperthyroidism Subtotal Thyroidectomy: ? exercises of the neck ? days after discharge

A

ROM
3-4 days

51
Q

Sudden, life-threatening exacerbation of hyperthyroidism/thyrotoxicosis

A

Thyroid Crisis/Storm

52
Q

Thyroid Crisis Causes

A

Stress, Infection, Unprepared Thyroid Surgery

53
Q

Thyroid Crisis Causes: taking medications that increase thyroid hormones

A

Salicylates (ASA)

54
Q

Thyroid Crisis CM: Initial sign

A

Elevated Temperature (Fever)

55
Q

Thyroid Crisis CM: HR, BP, RR

A

Tachycardia
Hypertension
Tachypnea

56
Q

Thyroid Crisis CM: Neurologic State and Conciousness

A

Restlessness, Apprehension, Tremors, Delirium, Psychotic State, Coma

57
Q

Thyroid Crisis Interventions: Monitor?

A

BP, HR, RR, Temperature, I and O
Neurologic Status

58
Q

Thyroid Crisis Interventions: Keep environment ? and ? cool (? and ? as prescribed)

A

Quiet, Cool
Cooling Blankets, Sedatives

59
Q

Thyroid Crisis CM: No foods containing ? (seafood…seaweed, dairy, eggs)

60
Q

Thyroid Crisis Interventions: Administer increasing doses of oral ?- (? mg q ? hrs) as ordered, following a loading dose of ? mg. p.o as ordered

A

PTU, 200-300mg, 6hrs
800-1,200mg

61
Q

Thyroid Crisis Interventions: Administer ? to help inhibit the release of thyroid hormone
Administer ? to control hypertension and tachycardia

A

Dexamethasone
Propranolol

62
Q

Thyroid Crisis Interventions: Implement measures to lower fever
- cooling devices
- cold baths
- ? (avoid ?)

A

Acetaminophen
Aspirin

63
Q

hyposecretion of thyroid hormones

A

Hypothyroidism

64
Q

characterized by a decreased rate of body
metabolism

A

Hypothyroidism

65
Q

thyroid gland cannot produce the necessary amount of hormones

A

Primary Hypothyroidism

66
Q

thyroid is not being stimulated by the pituitary gland to produce hormones

A

Secondary Hypothyroidism

67
Q

Decrease T3 = Decrease metabolic rate
Decrease T4 = Decrease body heat production
Decrease Thyrocalcitonin = Increase calcium

A

Hypothyroidism

68
Q

Hypothyroidism Causes: an autoimmune disorder in
which your immune system inappropriately attacks your thyroid gland causing an inflammation

A

Hashimoto’s Disease or Chronic Lymphocytic Thyroiditis

69
Q

Hypothyroidism Causes:
after surgery ?
after radiation therapy ?
? drugs

A

Thyroidectomy
Radioactive Iodine
Antithyroid

70
Q

Hypothyroidism CM: ? Hair, Loss of ? Hair, ? Face

A

Dry, Coarse Hair
Eyebrow
Puffy

71
Q

Hypothyroidism CM: Swelling of the skin (eyes and face) that gives it a waxy appearance

Dull, ? , mask-like ?

A

Myxedema
Expressionless, Face

72
Q

Hypothyroidism CM: ? Skin, ? Nails

A

Dry
Brittle

73
Q

Hypothyroidism CM: Weight Gain? , ? Pain

A

Hyperlipidemia & Atherosceloris
Muscle

74
Q

Hypothyroidism CM:
Slow ?
? voice
? tongue

A

Slowed
Husky, Hoarse
Enlarged

75
Q

Hypothyroidism CM: Irregular menstruation

A

Menorrhagia, Amenorrhea

76
Q

Hypothyroidism CM: GI Disturbance

A

Constipation
Anorexia

77
Q

Hypothyroidism CM: ? physical, mental reactions, ?
Extremely tired and ?

A

Slowed, Apathy
Fatigue

78
Q

Hypothyroidism CM: ? intolerance, ? temperature

HR ?

A

Cold, Subnormal
Bradycardia

79
Q

Hypothyroidism Intervention: Monitor ?

A

VS (HR, BP, EKG)
Weight daily

80
Q

Hypothyroidism Intervention: Diet, Encourage ?

A

Low Calorie, High Fiber
Fluids

81
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement

A

Proloid (Thyroglobulin)
Synthroid (Levothyroxin)
Dessicated Thyroid Extract
Cytomel (Liothyronine)

84
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Most Common

A

Synthroid (Levothyroxine)

85
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Before administration, the nurse should monitor ? & ?

86
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Start with ? and gradually ?

A

Low dose
Increase

87
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Don’t ? taking (takes a while for signs and symptoms to improve)

A

abruptly stop

88
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Take at the ? every day in the morning without ?

A

Same time
Food

89
Q

Hypothyroidism Pharmacotherapy: Thyroid hormonal replacement - Don’t take within ? of multivitamins, GI medications like Carafate, aluminum hydroxide, simethicone….decreases absorption of thyroid medication

90
Q

Hypothyroidism Pharmacotherapy: Note patients with hypothyroidism are sensitive to narcotics like ? (avoid dilaudid, morphine, fentanyl) and other ? (could lead to myxedema coma). Instead use alternatives for pain as prescribed like non-narcotics ?

A

Opoids, Sedatives
Tylenol, Ibuprofen

91
Q

Extreme, severe stage of hypothyroidism, in which the
client is hypothermic and unconscious

A

Myxedema Coma

92
Q

Myxedema Coma CM: ? (not just cold intolerance)

A

Hypothermia

93
Q

Myxedema Coma CM: swelling of tissues that have a waxy appearance or orange peel texture which will be located on the eyes and face

94
Q

Myxedema Coma CM: ? heart rate and ? blood pressure
? failure (most likely will need mechanical ventilation)

A

Slow, Low
Respiratory

95
Q

Myxedema Coma CM: due to the increased antidiuretic hormone which causes the body to conserve water & decreased glomerular filtration rate because there is decreased blood flow to the kidneys

A

Hyponatremia

96
Q

Myxedema Coma CM: due to the reduced metabolic rate hence decreased gluconeogenesis

A

Hypoglycemia

97
Q

Myxedema Coma CM: Very ? may progress to a coma

A

Confused/Drowsy

CMPA412 (7 decks)

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