Term
| Management of Hypothyroidism |
|
Definition
| Replacement hormone therapy |
|
|
Term
| Hyperthyroidism management |
|
Definition
| Subtotal thyroidectomy, radioactive iodine, anti-thyroid medications |
|
|
Term
| Thyroid replace prototype |
|
Definition
| Levothyroxine (synthroid) |
|
|
Term
| Levothyroxine (synthroid) Effects |
|
Definition
| Regulates metabolism, growth and development |
|
|
Term
| Levothyroxine (synthroid) is used for? |
|
Definition
| Replacement therapy. Hypothyroidism |
|
|
Term
| Levothyroxine (synthroid) S/E |
|
Definition
| None, except hyperthyroid symptoms |
|
|
Term
| Levothyroxine (synthroid) nursing implications |
|
Definition
| Monitor V.S., weight, bowel elimination, monitor T3,T4 and TSH levels |
|
|
Term
|
Definition
|
|
Term
| Propylthiouracil (PTU) Effects |
|
Definition
| Inhibits thyroid hormone synthesis |
|
|
Term
| When do we use Propylthiouracil (PTU)? |
|
Definition
|
|
Term
| Propylthiouracil (PTU) S/E |
|
Definition
| Hypothyroid s/e, some NV, rash |
|
|
Term
| How long do you take Propylthiouracil (PTU)? |
|
Definition
| 12-24 months then stop and see if in remission. Take with food |
|
|
Term
| How long do you take synthroid? |
|
Definition
|
|
Term
| How long does it take synthroid to reach therapeutic levels/ |
|
Definition
|
|
Term
| How should you store synthroid? |
|
Definition
| In a dark container. Avoid foods that inhibit thyroid secretions when taking it. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What do hormones regulate? |
|
Definition
| Secretory and motor activities of the GI tract, energy production. composition and volume of ECF, immunity, growth and development, reproduction and lactation |
|
|
Term
|
Definition
| No. They are inactivated by enzymes or excreted via urine |
|
|
Term
|
Definition
| When a hormone level rises above normal, another hormone is secreted to bring it down or inhibit it. |
|
|
Term
| 4 main reasons we use hormone therapy |
|
Definition
1. Replacement
2. Effects beyond replacement
3. Endocrine diagonistic testing
4. Cancer therapy |
|
|
Term
| What parts of the body are involved in the thyroid negative feedback loop |
|
Definition
| The hypothalamus and pituitary gland. |
|
|
Term
| Thyroid negative feedback loop |
|
Definition
| TRH, which then causes the anterior pituitary gland to secrete TSH, which then causes the thyroid gland to secrete T3/T4 which regulate body metabolism. |
|
|
Term
|
Definition
|
|
Term
| What is required for thyroid gland to produce hormone? |
|
Definition
|
|
Term
| What is the most common source of iodine in the US? |
|
Definition
| Iodized salt or shellfish |
|
|
Term
| Effects of thyroid hormones |
|
Definition
| Growth/maturation, cerebral development in 1st year, metabolic rate, fluid and electrolyte balance, cardio function, muscle function, temp regulation, lactation |
|
|
Term
|
Definition
1. Lethargy
2. Stunted growth
3. Higher cholesterol levels
4. Constipation
5. bradycardia
6.decreased muscle function |
|
|
Term
|
Definition
1.Fine muscle tremors
2. Excitability/irritability
3. Tachycardia |
|
|
Term
|
Definition
| Can be both hyper and hypo. Enlargement of the thyroid gland |
|
|
Term
|
Definition
| Due to iodine diet deficiency |
|
|
Term
|
Definition
| Hyperthyroidism. Stimulated to be overactive and thus enlarges |
|
|
Term
|
Definition
| Hypothyroidism. Inflammation within thyroid gland. Impairs hormone production. Body attempts to stimulate thyroid gland to produce hormones, but instead it just enlarges |
|
|
Term
|
Definition
|
|
Term
| What is the most preferred value for diagnosing thyroid disorders and monitoring the progression of disease? |
|
Definition
|
|
Term
|
Definition
| 0.35-5.5mU/ML (US: 0.3-3.0) |
|
|
Term
|
Definition
| Used if a nodule is present to find if it is malignant or not |
|
|
Term
|
Definition
| Abnormality in the thyroid gland itself. Decreased T3, T4 levels and ELEVATED TSH |
|
|
Term
|
Definition
| results when the pituitary gland is dysfunctional and does NOT secrete TSH |
|
|
Term
|
Definition
| Results when the hypothalamus gland does not secrete TRH. (So TSH release is not stimulated) |
|
|
Term
|
Definition
| Fatigue, weight gain, coarse dry hair, rough pale skin, cold intolerance, muscle cramps, constipation, depression, irritability, memory loss, heavy menstrual cycles, decreased libido |
|
|
Term
| Congenital Hypothyroidism: Cretinism |
|
Definition
| Low/no thyroid level present at birth. |
|
|
Term
|
Definition
| Dwarfism, thick coarse skin, thick tongue, protruding abdomen, thick short legs, poorly developed hands and feet |
|
|
Term
| How can we combat cretinism? |
|
Definition
| Hormone therapy in the first 6 weeks. Can lead to normal growth. Tx can be lifelong. TX cannot reverse mental retardation that has already occurred. |
|
|
Term
| Is it a cretinism screen required by law? |
|
Definition
|
|
Term
| Older children/adults: Myxedema |
|
Definition
| A type of edema that occurs in the connective tissues of the body. Can lead to coma and death |
|
|
Term
|
Definition
| Puffy, expressionless face |
|
|
Term
|
Definition
| Primary, secondary, or tertiary hypo-T. Radiation of thyroid, hashimoto's |
|
|
Term
| What is synthroid a synthetic form of? |
|
Definition
|
|
Term
| How well is synthroid absorbed in the GI tract? |
|
Definition
| Not well. Incomplete absorption, although this varies by brand |
|
|
Term
|
Definition
|
|
Term
| Duration of action for synthroid |
|
Definition
|
|
Term
| Where is synthroid excreted |
|
Definition
|
|
Term
| Adverse effects of synthroid are related to what? |
|
Definition
|
|
Term
| Natural thyroid replacement |
|
Definition
| Derived from tissue of cattle or hogs. |
|
|
Term
|
Definition
| 4.22 parts T4 to one part of T3. (natural thyroid is closer to this) |
|
|
Term
| Synthetic thyroid replacement ratio |
|
Definition
|
|
Term
| What effect do thyroid meds have on anticoagulents? |
|
Definition
|
|
Term
| Questran thyroid replacement interaction |
|
Definition
| Binds to the agents and decreases absorption. Have to separate medication admin by 4 hours |
|
|
Term
| Anti-acids Carafate with thyroid meds |
|
Definition
| Carafate decreases thyroid replacement absorption. Take at least 1 hour apart |
|
|
Term
| When is the BEST time for a patient to take their thyroid replacement medications? |
|
Definition
| Right in the morning on an empty stomach. Same time every day. Take missed dose as soon as remembered, don't switch brands. |
|
|
Term
| What foods interact with thyroid replacement therapy? |
|
Definition
| Turnips, cabbage, peaches, peas, strawberries, spinach, radishes |
|
|
Term
|
Definition
| Elevated t3 and t4, decreased TSH |
|
|
Term
| Most common cause of hyperthyroidism |
|
Definition
|
|
Term
|
Definition
| occurs between 20-40. More in female. Familial tendency. |
|
|
Term
|
Definition
| High levels of thyroid hormone. |
|
|
Term
|
Definition
| patient will have a very high body temp such as 105-106. Aspirin should NOT be used to bring down fever. Displaces thyroid. Worsens the storm. Medical emergency |
|
|
Term
|
Definition
| palpitations, heat intolerance, nervousness, insomnia, diarrhea, light or absent periods, staring gaze, fast heart rate, tremors, weight loss, muscle weakness, warm moist skin, hair loss |
|
|
Term
| hyperthyroidism radioactive iodine |
|
Definition
| Destroys part of the gland. takes about 3-4 months |
|
|
Term
|
Definition
|
|
Term
| What percent of pts on PTU will develop Leukopenia? (decreased WBC count) |
|
Definition
|
|
Term
| Anti-Thyroid agents and coagulants |
|
Definition
| DECREASE anti-coagulant effect |
|
|
Term
| Food interactions with Anti-Thyroid agents |
|
Definition
| Seafood and iodized salt (overstimulates it when we are trying to shut down the function) |
|
|
Term
| Anti-Thyroid agents toxicity |
|
Definition
| Liver and bone marrow toxicity. Monitor CBC |
|
|
Term
| Anti-Thyroid agents and Agranulocytosis |
|
Definition
| Fever, chills, sore throat, hoarseness |
|
|
Term
| Anti-Thyroid agents pt education |
|
Definition
1. May take 6 months to years
2. Take same time every day
3. Take WITH meals
4. Never stop abruptly |
|
|
