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Thyroid Disorders
Week 2
29
Nursing
Not Applicable
01/19/2013

Additional Nursing Flashcards

 


 

Cards

Term
Decribe Graves Disease
Definition

An autoimmune disorder.   Pts develop antibodies to the TSH receptor. These antibodies attach to receptors and stimulate the thyroid gland to secrete T4, T3 or both.

 

Term
How is hyperthyroidism diagnosed?
Definition

 

decreased TSH levels and elevated (free T4) levels. T3 T4 freeT4, thyroid antibodies, T3 uptake test, Thyroid scan/ RAIU (Radioactive Iodine Uptake)

Generally tx of choice

Graves disease: RAUI test used to differentiate between Graves disease and other thyroiditis. With show an uptake of 35-95%.

 

 

 

 

 

 

Term
Name the diagnostic tests for hyperthyroidism
Definition

TSH

T3, T4, and free T4

Thryoid antibodies

T3 uptake test

Thyroid scan

RAIU

Term
What are they symptoms of hyperthroidism?
Definition

hyermetabolism

heat intolerance

weight loss

increased appetite

increased beta activity

palpitations

tachycardia

A-fib

diarrhea insomnia anxiety

Term
what is the most common cause of hyperthyroidism
Definition
Graves disease
Term
what are the manifestations of graves disease
Definition

goiter

enlarged thyroid with excessive hormone secretion

exophthalmos

changes in menstruation

most common in women ages 20-40

Term
what are the main concerns of exophthalmos?
Definition
dry cracky eyes that can develop ulcers or the person can become blind
Term
What is the goal for hyperthyroid treatment?
Definition
To block the adverse effects of the thyroid hormones and stop thier oversecretion.
Term
what are the 3 main treatment options for hyperthyroidism?
Definition

1. antithyroid medications

2. radioactive iodine therapy

3. subtotal thyroidectomy

Term
what are the goals for tx of hyperthyroidism and what is it treated with?
Definition

STOP THYROID HORMONE SECRETION AND MANAGE THE SYMPTOMS

  1. Medications
  2. thyroid ablation
  3. thyroidectomy
  4. nutrition
Term
Describe the medications that are used for hyperthroidism
Definition

1. Beta blockers inhibit adrenergic effects for palpitations, tachycardia, A-fib, symptomatic relief of thyrotoxicosis: Propronalol. Atenolol for asthama and heart disease

 

2. Antithyroid medications: inhibits synthesis of thyroid hormone and interferes with iodine utilization. May be used before surgery. (PTU) Propylthiouracil. Methimazole.

 

3. Iodine (SSKI- saturated solution of Potassium Iodine, Lugols solution): Large doses inhibit synthesis of T3 and T4 and block thier release into circulation.

 

Term
Describe and name the iodine medication for hyperthyroidism
Definition

Saturated solution of potassium iodine-SSKI, Lugols solution

Large amounts rapidly inhibit they synthesis of T4 and T3 and block thier release into circulation

Used with antithyroid medications before subtotal thyroidectomy or tx of thyroidtoxic crisis

Decreases vascularization so makes surgery easier and safer.

Short term use because therapeutic effects are decreased over time.

Term
Name and describe the use of antithyroid medications
Definition

PTU- propylthiouracil. Methimazole.

Inhibits the synthesis of thyroid hormones and interferes with iodine utilization.

May be used before surgery

Term
Describe radioactive iodine therapy.
Definition
  • Thyroid ablation.Damages or shrinks thyroid tissue, limiting thyroid hormone secretion
  • Treatment of choice for most nonpregnant adult pts.
  • Can cause hypothyroidism.
Term
Describe the nutrition requirements for hyperthyroid patients.
Definition
High calorie, increase carb intake to prevent tissue damage. Avoid highly seasoned of fiber foods because they could stimulate and already hyperactive GI. Substitute caffine because it could increase the reslessness and sleep disturbances.
Term
Describe subtotal thyroidectomy and interventions that follow it.
Definition
  • Surgical remivol of 90% of thyroid.
  • Indicated for pts with large goiter that causes tracheal compression, pts unresponsive to antithyrod therapy, thyroid cancer or pts not candidate for RAI.
  • Assess pt q2hrs for 24 hrs Semi-fowlers position. Monitor vital signs, check for Ca deficeincy-tetnay,Trousserous and Chvokes sign.
  • Post op: decrease calorie intake to promore weight loss. Adequate iodine intake- but not too much. Avoid high temp because it inhibits thyroid regeneration. Watch out for hematoma, swelling and airway restriction.

Total thyroidectomy can cause damage to parathyroid glan, laryngeal nerve damage- horse voice

 

Term

Describe the post care of thyroidectomy

 

Definition
  • hemorrhage.
  • Key Assessment!   Monitor for airway obstruction; inflammation, swelling, Ca:  have tracheostomy tray at bedside.
  • hypocalemia-tetany
  • hypothyroidism
  • hoarsness- may go away 
Term
Nursing Focus for thyroidectomy
Definition
  • diet-  frequent meals
  • activity- scheduled rest time
  • monitor pt for comlications: A-fib, tachycardia, airway obstruction
  • pre/post surgical care
  • prevent corneal injury
  • medicaion and self care teaching
Term
Thyrotoxic Crisis (Thyroid Storm): what is it, what triggers it and what are the S/S?
Definition
  • excess thyroid hormone and increased sensitivity to symptoms
  • triggered by: Infection, trauma, manipuation during OP
  • S/S: death due to cadiac complications-if untreated. abrupt onset, hyperthermia 102-106, metabolic acidosis, dehydration
Term
What are the interventions for thyroitoxic crisis (thyroid strom)?
Definition

Start antithyroid medications ASAP. colling blanket, tylenol, cardiac monitoring, dexamethasom-steriod med that suppresses T3 and T4 release.

 

Do not use aspirin because it increases T3 and T4.

Term
What are possible nursing diagnosis for hyperthyroidism?
Definition
  • altered nutrition
  • activity intolerance
  • risk for injury (corneal ulceration)
  • disturbed body image
Term
What is the most common medical disorder in the U.S.?
Definition
Hypothyroidism
Term
What is hypothyroidism?
Definition
Insuffiecient circulation of thyroid hormones on the body.
Term
Cretinism
Definition
Hypothyroidism developed in infancy.
Term
What are drugs that can cause hypothyroidism?
Definition

Amiodarone (Cordarone)- contains iodine

Lithium- blocks hormone production

 

 

Term
What is the most common cause of hypothyroidism?
Definition

Iodine deficiency.

 

Term
Why is dexamethasone used to treat thyroid storm?
Definition
It's a steriod medication that suppresses T4 T3 release.
Term
What is the treatment for hyperthermia for a patient with a thyroid storm?
Definition
Tylenol and a cooling blanket
Term
What medication can you NOT use for the treatment of hyperthermia in thyroid storm?
Definition
Aspirin- it increases the T3 and T4 hormone because it inhbits protein binding.
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