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MED SURG > TOPIC 1 - hypo and hyperthyroidism > Flashcards

TOPIC 1 - hypo and hyperthyroidism Flashcards

1
Q

excessive hyperthyroidism

A

thyrotoxicosis

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2
Q

excessive hypothyroidism

A

myxedema coma

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3
Q

primary hypothyroidism

A

destruction of thyroid tissue or defective hormone synthesis

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4
Q

secondary hypothyroidism

A

pituitary disease with decreased TSH or hypothalamic dysfunction with decreased TRH

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5
Q

most common cause of hypothyroidism

A

iodine deficiency

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6
Q

graves is related to

A

hyperthyroid

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7
Q

hashimotos is related to

A

hypothyroid

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8
Q

most common cause of primary hypothyroidism

A

atrophy of thyroid gland

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9
Q

hypothyroidism may develop after …

A

treatment for hyperthyroidism, RAI therapy, thyroidectomy

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10
Q

manifestations of hypothyroidism

A

systemic effects (slowing body process), fatigue, lethargy, personality and mood change, impaired memory, decreased initiative somnolence, depression, weight gain, slowed speech

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11
Q

cardio relationship to hypothyroidism

A

decreased cardiac contractility and decreased cardiac output - low exercise tolerance and shortness of breath
coronary atherosclerosis - increased cholesterol and triglyceride level
anemia

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12
Q

lab values of hypothyroidism

A

normal T4 and increased TSH

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13
Q

management of hypothyroidism

A

levothyroxine - monitor heart rate (report over 100 bpm), lifelong therapy and follow up care
nutritional therapy to promote weight loss

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14
Q

avoid ___ with hypothyroidism

A

sedatives - monitor LOC and RR
enemas - vagal stimulation = cardiac issues

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15
Q

hyperthyroidism causes

A

thyroiditis, excess iodine, pituitary tumor, thyroid cancer, toxic nodular goiter, graces disease

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16
Q

early signs of hyperthyroidism

A

weight loss, increased nervousness

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17
Q

manifestations of hyperthyroidism

A

hypertension, bounding pulse, angina, dysrhythmias, CHF, fatigue
dyspnea, increased RR
weight loss, increased appetite and thirst, increased peristalsis, increased bowel sounds
warm, moist skin, brittle nails, diaphoresis
difficulty sleeping, tremors, edema, osteoporosis, delirium, lack of concentration
menstrual abnormalities, gynecomastia, decreased fertility
intolerance to heat, elevated basal temp

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18
Q

teaching for hyperthyroidism

A

elevate HOB at night, eye drops, dark glasses for photophobia, steroid therapy for swelling, diuretics for edema

19
Q

labs for hyperthyroidism

A

low TSH, elevated T4

20
Q

antithyroid drugs

A

methimazole, propylthiouracil, iodine, propranolol, atenolol, metoprolol

21
Q

nutritional therapy for hyperthyroidism

A

high calorie, high protein, frequent meals, avoid highly seasoned food and high fiber foods (GI effects), avoid caffeine (decrease restlessness)

22
Q

what causes exophtalmos

A

increased fat deposits and fluid in the orbital tissues and ocular muscles

23
Q

primary lab finding to confirm diagnosis of hyperthyroid

A

low TSH

24
Q

the RAIU test can…

A

distinguish graves disease from other forms of thyroiditis

25
Q

treatment options for hyperthyroid

A

antithyroid meds, radioactive iodine therapy, surgery

26
Q

supportive therapy of hyperthryoidism

A

manage resp distress, reduce fever, replace fluids, eliminate stressors

27
Q

propylthiouracil vs methimazole

A

propyliouracil achieves goal quicker, but is taken 3 times per day
methimazole is given in a single daily dose

28
Q

what happens upon abrupt stops of meds

A

return to hyperthyroid state

29
Q

the use of iodine with other antithyroid drugs

A

prepare patient for thyroidectomy or for treatment of thyroxicosis

30
Q

is long term iodine therapy effective

A

no

31
Q

signs of iodine toxicity

A

swelling of buccal mucosa and other mucous membranes, excess salivation, nausea and vomiting, skin reactions

32
Q

beta blockers are used for what purpose related to hyperthyroidism

A

symptomatic relief to decrease tachycardia, nervousness, irritability, tremors

33
Q

what is the preferred b blocker for hyperthyroidism

A

atenolol

34
Q

after RAI treatment, what cautions should patients take to limit exposure to others

A

private toilet, flush 2-3 times, separate laundry, do not prepare food for others, avoid being close to pregnant women or children
(up to 7 days)

35
Q

who are candidates for a thyroidectomy

A

patients with a large goiter causing tracheal compression, those with a lack of response to antithyroid therapy, people with thyroid cancer

36
Q

postoperative complications of thyroidectomy

A

hypothyroid, damage to parathyroid, hypocalcemia, hemorrhage, injury to laryngeal nerve, thyrotoxicosis, infection

airway obstruction = emergency, keep O2 on hand

37
Q

position for postoperative patients

A

semi fowlers and support the head with pillows

38
Q

subclinical hypothyroidism occurs when

A

TSH is greater than 4.5 but the T4 levels are normal

39
Q

drugs causing hypothyroidism

A

amiodarone (which contains iodine), lithium (which blocks hormone production)

40
Q

there are significant cardiovascular problems in hypothyroid patients who also have ….

A

CVD
it is associated with decreased cardiac contractility and decreased cardiac output

41
Q

what causes myxedema

A

results from accumulation of hydrophilic mucopolysaccharides in the dermis and other tissues = puffy subcutaneous tissues, facial and periorbital edema, and a masklike affect

42
Q

difference in thyroid defect and pituitary or hypothalamus defect

A

serum TSH is high when defect is in the thyroid
TSH is low when it is in the pituitary or hypothalamus

43
Q

nutritional therapy of hypothyroidism

A

low calorie diet

44
Q

drug of choice to treat hypothyroidism and implications of it

A

levothyroxine

lifelong therapy, do not stop abruptly or switch brands

begin with low doses and monitor for cardiovascular complications

may take up to 8 weeks before therapy is effective

take in the morning before food

MED SURG (30 decks)

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