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23 Cards in this Set
- Front
- Back
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Hypothyroidism - Primary (Labs)
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TSH - increase
T4 - decrease |
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Hypothyroidism - Secondary (Labs)
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TSH, T3, T4 decrease
if TSH stays low after injection of TRH |
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Hypothyroidism - Tertiary (Labs)
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TRH, TSH, T3, T4 decreased
if TSH increases after injection TRH |
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S/S Hypothyroidism
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no symptoms
fatigue, lethargic, impaired memory, slowed speech, SOB, anemia, bruise easily, dry & coarse hair, constipation, cold intolerance, brittle nails, hoarseness, weight gain, periorbital edema |
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Hypothyroidism - Primary Treatment
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~levothyroxine (Synthroid) - lifelong replacement
~low calorie diet |
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problems resulting of hypothyroidism
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Low metabolic rate, sensitivity to cold, constipation, edema, heightened sensitivity to sedative-hypnotic medications, disorientation, myexedema coma
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Hyperthyroidism Names
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Graves Dz
Thyrotoxicosis Hyperthyroidism |
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Hyperthyroidism Etiology
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an autoimmune dz, (unknown) marked by diffuse thyroid enlargement & excessive thyroid hormone secretions.
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Precipitating Factors to Hyperthyroidism
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decrease iodine, infections, stressful life events
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Hyperthyroidism Patho
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develops antibodies, they attach to the TSH receptors and stimulate gland to release T3, T4, or both. excessive release may progress to destruction of tissue leading to hypothyroidism
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Hyperthyoidism S/S
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SOB, weight loss, diarrhea, heat intolerance, diaphoresis, mood swings, increase appetite, fatigue, nervousness, increase: RR, HR, Pulse, Bowel sounds, exophtalamia
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hyperthyroidism geriatrics s/s
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anorexia, apathy, lassitude, depression, weight loss, atrial fib, confusion, angina & CHF
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Hyperthyroidism 3 treatments
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Drug Therapy
Radioactive Iodine Therapy Surgical Therapy |
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Hyperthyroidism Drug Therapy Types
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Antithyroid - propylthiouracil (PTU) & methimazole (Tapazole)
Iodine (SSKI) Beta-Blockers - propranolol (Inderal), atenolol (Tenormin) |
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Radioactive Iodine Therapy
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damages thyroid tissue & limits hormone secretion, delayed response (2-3months). usually treated propranolol & antithyroid for 3 months during lapse, most ppl become hypothyroid as result
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Surgical Therapy Hyperthyroidism
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Thyroidectomy- rapid reduction T3 & T4
Subtotal: remove 90% Endoscopic : Sm Nodes (<3cm), no malignancy |
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Problems from Hyperthyroidism
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Weakness & Exhaustion, can't close eyes, hungry all the time, gastric irritability, restless, worried
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PreOp for subtotal thyroidectomy
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Cardiac problems need to be controlled first (achieve euthyroid state), administer Iodine to decrease vascularity if ordered, educate TCDB, leg exercises, how to move neck and support head after surgery, room ready w/ oxygen, suction, trach tray, IV calcium salts available Ca++ gluconate or gluceptate
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Complications of thyroidectomy
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iodine toxicity, dyspnea, hemorrhage, tetany
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Iodine Toxicity CM
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swelling of buccal & mucus membranes, excessive salivation, skin reactions
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Addisonian Crisis
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a life-threatening disorder caused by adrenal hormone insufficiency. Crisis is precipitated by infection, trauma, stress or surgery. Death can occur from shock, vascular collapse or hyperkalemia
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Addison's DZ
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hyposecretion of adrenal cortex hormones (flucocorticoids and mineralocortocoids) from the adrenal gland, resulting in deficiency of the corticosteriod hormones. Condition is fatal if left untreated
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Adrenalectomy
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surgical removal of an adrenal gland. Lifelong replacement of glucocortiicoids and mineralocorticoids is necessary with a bilateral adrenalectomy. Temporary replacement may be necessary for up to 2 years for a unilateral adrenalectomy
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