Term
Hypothyroidism
deficiency in thyroid hormones |
|
Definition
1. Primary: abnormality in the thyroid gland itself (most common)
2. Secondary: results when pituitary gland is dysfunctional and does not secrete TSH
3. Tertiary: results when the hypothalamus gland does not secrete TRH, which stimulates the release of TSH |
|
|
Term
|
Definition
1. hyposecretion of thyroid hormone during youth
2. low metabolic rate, retarded growth and sexual development, possible mental retardation |
|
|
Term
|
Definition
1. hyposecretion of thyroid hormone during adulthood
2. decreased metabolic rate, loss of mental and physical stamina, weight gain, loss of hair, firm edema, yellow dullness of the skin |
|
|
Term
|
Definition
1. enlargement of the thyroid gland
2. result from overstimulation by elevated levels of TSH
3. TSH is elevated because there is little or no thyroid hormone in circulation |
|
|
Term
Hypothyroidism
Common symptoms |
|
Definition
1. thickened skin
2. hair loss
3. constipation
4. lethargy
5. anorexia |
|
|
Term
Hypothyroidism
Thyroid Replacement Drugs |
|
Definition
1. Levothyroxine (Sythroid, Levothyroid) - synthetic thyroid hormone T4
2. liothyronine (Cytomel) - synthetic thyroid hormone T3
3. liotrix (Thyrolar) - synthetic hormone T3 and T4 combined
4. thyroid - desiccated (dried) animal thyroid gland |
|
|
Term
Hypothyroid drugs
Adverse effects |
|
Definition
1. Cardiac dysrhythmia - most significant
2. may also cause: tachycardia, palpitations, angina, hypertension, insomnia, tremors, headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss, appetite changes, sweating, heat intolerance, others |
|
|
Term
| Hypothyroid - Levothyroxine |
|
Definition
1. give at same time each day - usually in morning (insomnia)
2. note that dosing is mcg/not mg
3. pts will take for rest of life
4. avoid changing manufacturers (bioequivalence prob.)
5. discontinue 4 weeks prior to radioactive iodine isotope studies
6. the elderly may require smaller dose - start low and go slow |
|
|
Term
Hypothyroid = Levothyroxine
Nursing Implications II |
|
Definition
1. continue hypothyroidism treatment during pregnancy
2. fetal growth may be retarded if maternal hypothyroidism is untreated
a. adjust dosage every 4 weeks to keep TSH at lower end of normal |
|
|
Term
Hypothyroid - Levothyroxine
Nursing Implications III |
|
Definition
1. teach pts to report unusual symptoms, chest pain, heart palpitations
2. teach pts not to take OTC meds w/o dr approval
3. teach pts that therapeutic effects maytake 3-4 weeks to occur |
|
|
Term
|
Definition
1. several diseases cause it - Grave's, multinodular disease, Plummer's disease (rare - also called toxic nodular disease)
2. Thyroid storm (induced by stress or infection) - severe and can be potentially life-threatening |
|
|
Term
|
Definition
1. overall increase in metabolism
2. diarrhea 3. flushing
4. increased appetite
5. muscle weakness 6. sleep disorders
7. altered menstrual flow 8. fatigue
9. palpitations 10. nervousness 11. heat intolerance
12. irritability |
|
|
Term
Hyperthyroidism
Treatment |
|
Definition
1. Radioactive iodine works by destroying the thyroid gland
2. surgery to remove all or part of the thyroid gland and lifelong thyroid hormone replacement will be needed |
|
|
Term
Hyperthyroidism
Antithyroid drugs |
|
Definition
thiomide derivatives
a. methimazole (Tapazole)
b. propylthiouracil (PTU)
Used to palliate hyperthyroidism and to prevent surge in thyroid hormones that occurs after surgical treatment
May cause liver and bone marrow toxicity |
|
|
Term
| A pt has been taking levothyroxine for 6 months. After this month's lab work, the nurse practicioner tells the nurse that the patient is "Euthyroid." What does that term mean? |
|
Definition
| The patient's thyroid hormone levels are within normal limits |
|
|
Term
| A patient who is taking thyroid replacement medication tells the nurse that she is starting to experience cold intolerance, depression, constipation, and dry skin. The nurse anticipates that these manifestations are caused by |
|
Definition
inadequate doses of the medication
a return to the symptoms of hypothyroidism indicates that the pt is receiving inadequate doses |
|
|
Term
| Which information will nurse include when teaching a pt about thyroid replacement therapy? |
|
Definition
Take medication on an empty stomach
best taken 1/2 hour to 1 hour before breakfast to enhance absorption, maintain hormone levels and prevent insomnia. do not discontinue abruptly, lifelong therapy is the norm. 3-4 weeks to see effects |
|
|
Term
| Which would be the best menu choice for a pt who is taking an antithyroid med? |
|
Definition
Pasta with marinar sauce
Foods such as soy, tofu, and seafood are high in iodine |
|
|
Term
thyrotoxicosis
(thyroid storm)
definition |
|
Definition
| a condition caused by excessive quantities of thyroid hormones (hyperthyroidism); it may be due to the overproduction by the thyroid gland, overproduction outside the thyroid or loss of storage function and leakage from the gland |
|
|
Term
|
Definition
| sudden weight loss, rapid heart beat, increased appetite, nervousness, tremor, sweating, changes in menses, increased sensitivity to heat, more frequent BMs, goiter, fatigue, weakness, insomnia, skin thinning, brittle hair |
|
|
Term
|
Definition
antithyroid drugs
surgery
radioactive iodine
sometimes beta blockers |
|
|
Term
| Contraindications to thyroid preparations include known drug allergy, recent _____________ infarction, adrenal _____________ , and hyperthyroidism. |
|
Definition
| myocardial; insufficiency |
|
|
Term
| One advantage of levothyroxine over the natural forms is that it is administered only ____________ a day because of its __________ half-life. |
|
Definition
|
|
Term
| Some of the more serious adverse effects of the thyroid drugs include _____________, palpitations and _________ pains. |
|
Definition
| cardiac dysrhythmia, chest |
|
|
Term
| Patients on antithyroid therapy should avoid _________ containing foods. These foods may interfere with the effectiveness of the antithyroid drug. |
|
Definition
|
|
Term
| Drug interactions with thyroid replacement preparations include ________, cholestyramine, and _____________ |
|
Definition
anticoagulants ; serum digitalis
may also induce coronary insufficiency if used with epinephrine.
diabetics mayneed more hypoglycemic drugs |
|
|
Term
| The signs of excess dosages of thyroid replacement hormone mimic those of ____________ and include nervousness, _____________ and ____________/ |
|
Definition
| hyperthyroidism; drowsiness and headache |
|
|
Term
|
Definition
1. most commonly prescribed synthetic thyroid hormone
2. chemically pure - 100% T4
long half life, once/day dosage
4. preg. category A
5. don't switch brands;
6. dosed in micrograms;
7. available in IV form and oral form |
|
|
Term
|
Definition
1. antithyroid drug
2. Preg. Category D
3. 2 weeks therapy necessary for therapeutic effects
4. only orally
5. most damaging adverse effect is liver and bone marrow toxicity |
|
|
