Term
| Is the thyroid as vascular as the liver? |
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Definition
it is 5 times more vascular |
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Term
| what is the function of the thyroid? |
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Definition
controls rate of body metabolism, chemical reactions, O2 consumpution, and energy production |
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Term
Other functions aided by the thyroid: |
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Definition
Physical/mental growth Central nervous system fluid & electrolytes reproduction immune system metabolism of CHO, fats, and proteins |
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Term
what is the function of TSH? |
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Definition
controls the rate of T3 & T4 release |
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Term
| high levels of T3/T4 & low levels of TSH is... |
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Definition
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Term
| low levels of T3/T4 & high levels of TSH is... |
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Definition
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Term
| what is the function of Calcitonin? |
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Definition
| reduces plasma calcium by depositing calcium in the bones |
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Term
| what does the thyroid need to make T3 & T4? |
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Definition
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Term
| how do you assess the thyroid? |
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Definition
inspect - visualization palpate for swelling, asymmetry, tenderness, nodularity from posterior position with hands encircling neck and have pt swallow auscultate over lobes for bruit |
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Term
| What are some Diagnostic Thyroid Function Tests? |
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Definition
Serum TSH Serum FT4 (free T4) Serum T3/T4 Serum thyroid antibodies Serum thyroglobulin Radioactive Iodine Uptake Fine Needle Aspiration Biopsy Thyroid Scan |
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Term
| What should the patient not consume before a radioactive iodine uptake test? |
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Definition
| avoid multi-vitamins, cough syrup, and ambioderon (not sure how that is spelled) |
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Term
| what are the precautions post-radioactive iodine test? |
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Definition
No blood/body fluid contact with others for 3 days. No exposure to children for 1 week. Sleep alone for 1 week. No Anti-thyroid medications for 6 weeks. |
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Term
| What are some outcomes of abnormal thyroid function? |
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Definition
cretinism hypothyroidism hyperthyroidism goiter euthyroid |
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Term
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Definition
stunted physical/mental growth caused by decreased thyroid hormone during fetal/neonatal development |
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Term
| what are some causes of hypothyroidism? |
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Definition
autoimmune thyroiditis (Hashimoto's disease) RAI - treatment for hyperthroidism surgical removal of thyroid antithyroid meds atrophy of thyroid related to aging |
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Term
| what are the two types of hypothyroidism? |
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Definition
1. primary (95% of the time)= it is a problem with the thyroid itself 2. central = pituitary/hypothalmus disfunction |
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Term
| Signs & Symptoms of Hypothyroidism |
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Definition
fatigue/irritability fluid retention decreased appetite - weight gain constipation dry skin hair loss/thinning hair hoarseness/husky voice menstrual disturbances/decreased libido cold intolerance = always complaining of being cold masklike face SOB slowed speech *remember everything is low & slow |
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Term
| what happens if hypothyroidism is untreated? |
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Definition
| pt can go into myxedema coma = decreased temp & unconsciousness |
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Term
| what are some treatments for hypothyroidism? |
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Definition
1. thyroid hormone replacement = synthroid, levothroid, and levothyroxine 2. supportive therapy = montior ABGs, VS, O2 sat, and BG. 3. prevent cardiac disfunction = Caution with O2, monitor for angina, dysrhythmias, MI |
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Term
| when should thyroid hormone replacements be administered? |
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Definition
| administer in the morning because it can keep the pt from being able to sleep. |
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Term
| what are some side effects of thyroid hormone replacements? |
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Definition
nervousness headache nausea & vomitting |
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Term
| what are some precautions with supportive therapy for hypothyroidism? |
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Definition
1. do not use heating pads to warm pt - could cause burns - use warming blanket 2. caution with po fluids - can cause fluid volume overload. 3. caution with hypnotics/sedatives because pt is already lethargic - resp & pulse is already low 4. caution with narcotics - monitor for stuper & resp failure |
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Term
| what are some interactions with levothyroxine (thyroid hormone replacement)? |
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Definition
1. increases BG - adjust insulin/po antidiabetic agents 2. increases effects of Dig., anticoagulants, and indomenthacin |
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Term
| what can lower the effects of synthroid? |
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Definition
| phenytoin/TC Antidepressants |
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Term
| Nursing Management for Hypothyroidism |
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Definition
modify activity - gradual return to ADLs Monitor VS & cognitive level provide extra clothing, warm blanket, & warm room provide emotional support |
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Term
| Discharge Teaching for Hypothyroidism? |
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Definition
Don't miss med doses involve family member in treatment Diet to promote weight loss Follow-up appt with lab work PRN Home Care |
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Term
| what is the most common hyperthyroidism disease? |
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Definition
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Term
| what is the 2nd most prevalent endocrine diagnosis after DM diagnosis? |
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Definition
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Term
are men or women more likely to have hyperthyroidism? |
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Definition
| women are 8x more likely - ages 30-50 |
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Term
| what causes hyperthyroidism? |
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Definition
high levels of T3/T4 low levels of TSH |
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Term
| what are the signs & symptoms of hyperthyroidism? |
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Definition
emotional hyperexcitability irritable apprehensive tachycardia - palpitations heat intolerant - perspire flushed warm, soft, moist skin fine hand tremor exopthalmos (bulging eyes) increased appetite - weight loss amenorrhea (no menstrual cycle) change in bowel function |
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Term
| Treatment Goals for hyperthyroidism? |
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Definition
reduce thyroid hyperactivity relieve signs and sypmtoms remove cause of complications |
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Term
| Different kinds of specific treatments for hyperthyroidism |
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Definition
1. radioactive iodine therapy - watch for thyroid storm - S/Sx resolve after 3-4 wks after treatment - radioactive precautions 2. Pharm therapy - antithyroid agents, iodides, & beta-adrenergic blocking agents 3. Surgical - thyroidectomy = remove all or part of the thyroid gland. |
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Term
| Pre - Op procedure for Thyroidectomy |
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Definition
examine vocal cords CXR No ASA Reduce anxiety - teach post op teach how to support neck with hands Increase CHO & Proteins |
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Term
| Post - Op Thyroidectomy procedures |
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Definition
quiet room Semi-fowlers - support head with pillows Analgesics for pain O2 - IVF Soft diet on day 2 Check/reinforce drsg Trach tray @ bedside Pt talk ASAP - damage to larnygeal nerve articles within reach watch for thyroid storm OOB asap - TCDB |
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Term
| what are parathyroid glands? |
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Definition
four rice grain sized glands embedded in thyroid they secrete parathormone which regulates Ca & Ph metabolism |
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Term
| what is hyperparathyroidism? |
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Definition
| overproduction of parathyroid hormone = hypercalcemia |
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Term
| causes of hyperparathyroidism |
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Definition
bone decalcification Ca containing renal stones @ risk = women ages 60-70 |
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Term
| S/Sx of hyperparathyroidism |
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Definition
fatigue - muscle weakness hematemesis n/v constipation cardiac arrhythmias emotional irritability neurosis - pancreatitis peptic ulcer disease extensive decalcification of bones - osteopenia formation of boney cysts and bone tumors |
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Term
| Treatments for hyperparathyroidism |
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Definition
Surgery - parathyroidectomy hydration mobility diet - decrease calcium & po phosphate meds |
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Term
| what causes hypoparathyroidism |
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Definition
inadequate parathyroid hormone secretion removed during thyroid surgery |
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Term
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Definition
tetany stidor = wheezing muscle tension/spasms dysphagia cyanosis pos chevostek sign = wink when you rub cheek pos trousseaus sign = adduct wrist when blowing up BP cuff abdominal pain spontaneous hair loss dry scaly skin |
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Term
| Treatments for hypoparathyroidism |
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Definition
IV Ca Gluconate/Ca Chloride sedatives (Phenobarb) anticovulsants parathormone aluminum hydroxide vit D/Ca supplements (tums/oscal) trach/bronchodilation meds |
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Term
| when giving calcium - what should you never do? |
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Definition
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Term
| Nursing Care for hypoparathyroidism |
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Definition
keep Ca gluconate @ bedside trach tray @ bedside seizure precautions high Ca / low Ph diet (avoid eggs, milk products, & spinach) quiet environment watch for decr COP lotion skin/ trim nails **Caution with Dig pts (Ca potientiates Dig = fatal dysrhythmics) |
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