NURS 354 COMPREHENSIVE EXAM UPDATED QUESTIONS
AND ANSWERS GRADED A+
✔✔hypothyroidism causes - ✔✔Hashimoto disease (autoimmune)*
atrophy of thyroid gland
radiation to head and neck
✔✔manifestations of hypothyroidism - ✔✔fatigue
weight gain
cold intolerance
dry skin
deepened voice
bradycardia
✔✔manifestations of SEVERE hypothyroidism - ✔✔subnormal body temp and pulse
rate
cachectic appearance
thickened skin
thin hair/hair falls out
dulled mental processes
✔✔myexedema coma - ✔✔decompensated state of sever hypoparathyroidism
- patient is hypothermic and unconscious
(most often in older women during the winter)
✔✔initial signs of myxedema coma - ✔✔depression
diminished cognitive status
lethargy
somnolence
✔✔levothyroxine (Synthroid) - ✔✔ACTION: increases tissues metabolic rate (increases
oxygen consumption, RR, and HR)
USE: hypothyroidism
ADVERSE: hyperparathyroidism, tachycardia, MI, angina
general range is 75-150 mcg/day
*increases effects of warfarin, bronchodilators, and vasopressors
*absorption may be affected by calcium, iron, zinc or mag
✔✔hormone levels in hypothyroidism - ✔✔decreased T3 and T4
increased TSH
, ✔✔hormone levels in hyperthyroidism - ✔✔increased T3 and T4
decreased TSH
✔✔labs seen in myexedma coma - ✔✔hyponatremia
hypoglycemia
hypothermia
bradycardia
✔✔thyroid cancer treatment - ✔✔thyroidectomy
✔✔Complications of thyroidectomy - ✔✔breathing risk (trachea is right by thyroid)
- monitor closely post-op
- have a tracheostomy kit at bedside
- notify provider at first sign of SOB
monitor for parathyroid injury
- hypocalcemia
✔✔hyperthyroidism causes - ✔✔Graves disease (autoimmune)*
toxic nodular goiter
toxic adenoma
thyroiditis
excessive ingestion of thyroid medication
✔✔manifestations of hyperthyroidism - ✔✔fine hair
muscle wasting
weight loss
tachycardia
exophthalmos
emotional instability
increased appetite
restless
enlarged gland
✔✔thyroid storm - ✔✔severe hyperthyroidism, usually of abrupt onset
✔✔manifestations of a thyroid storm - ✔✔hyperpyrexia (temp > than 101.3)
extreme tachycardia (> 130)
exaggerated symptoms
altered mental state
✔✔management of a thyroid storm - ✔✔reduce temperature
- ice packs
meds
- hydrocortisone
AND ANSWERS GRADED A+
✔✔hypothyroidism causes - ✔✔Hashimoto disease (autoimmune)*
atrophy of thyroid gland
radiation to head and neck
✔✔manifestations of hypothyroidism - ✔✔fatigue
weight gain
cold intolerance
dry skin
deepened voice
bradycardia
✔✔manifestations of SEVERE hypothyroidism - ✔✔subnormal body temp and pulse
rate
cachectic appearance
thickened skin
thin hair/hair falls out
dulled mental processes
✔✔myexedema coma - ✔✔decompensated state of sever hypoparathyroidism
- patient is hypothermic and unconscious
(most often in older women during the winter)
✔✔initial signs of myxedema coma - ✔✔depression
diminished cognitive status
lethargy
somnolence
✔✔levothyroxine (Synthroid) - ✔✔ACTION: increases tissues metabolic rate (increases
oxygen consumption, RR, and HR)
USE: hypothyroidism
ADVERSE: hyperparathyroidism, tachycardia, MI, angina
general range is 75-150 mcg/day
*increases effects of warfarin, bronchodilators, and vasopressors
*absorption may be affected by calcium, iron, zinc or mag
✔✔hormone levels in hypothyroidism - ✔✔decreased T3 and T4
increased TSH
, ✔✔hormone levels in hyperthyroidism - ✔✔increased T3 and T4
decreased TSH
✔✔labs seen in myexedma coma - ✔✔hyponatremia
hypoglycemia
hypothermia
bradycardia
✔✔thyroid cancer treatment - ✔✔thyroidectomy
✔✔Complications of thyroidectomy - ✔✔breathing risk (trachea is right by thyroid)
- monitor closely post-op
- have a tracheostomy kit at bedside
- notify provider at first sign of SOB
monitor for parathyroid injury
- hypocalcemia
✔✔hyperthyroidism causes - ✔✔Graves disease (autoimmune)*
toxic nodular goiter
toxic adenoma
thyroiditis
excessive ingestion of thyroid medication
✔✔manifestations of hyperthyroidism - ✔✔fine hair
muscle wasting
weight loss
tachycardia
exophthalmos
emotional instability
increased appetite
restless
enlarged gland
✔✔thyroid storm - ✔✔severe hyperthyroidism, usually of abrupt onset
✔✔manifestations of a thyroid storm - ✔✔hyperpyrexia (temp > than 101.3)
extreme tachycardia (> 130)
exaggerated symptoms
altered mental state
✔✔management of a thyroid storm - ✔✔reduce temperature
- ice packs
meds
- hydrocortisone
