Chamberlain University-Illinois NR 565
NR 565 Final Study Guide
WEEK 5 ...
Thyroid -TSH - used primarily for screening and diagnosing hypothyroid and for
o Diagnosis & Evaluation monitoring replacement therapy in hypothyroid patients
What labs are used to diagnose? -T4 - Used to monitor thyroid hormone replacement therapy and to screen for
thyroid dysfunction
-T3 - Useful in the diagnosis of hyperthyroidism; can also be used to monitor
hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Thyroid Recheck TSH 6-8 weeks after initiating therapy and after any dosage change;
o Diagnosis & Evaluation Check TSH at least once a year after serum TSH is stabilized
Timeframe for re-check of labs after starting
levothyroxine?
, Thyroid Hypothyroidism: Depend on severity.
o Diagnosis & Evaluation o Mild: subtle and may go unrecognized
o Moderate to severe:
Signs and symptoms of hypothyroidism? -Face is pale, puffy, and expressionless.
-Skin cold and dry.
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
-Patient may complain of lethargy, fatigue, and
-Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if reduced levels of T3
and T4
Mentation may be impaired.
Thyroid o Elevated Heart rate and strong, and dysrhythmias and angina may develop
o Diagnosis & Evaluation o The CNS is stimulated, resulting is nervousness, insomnia, rapid thought flow,
and rapid speech, hyperreflexia, tremors
Signs and symptoms of hyperthyroidism? o Skeletal muscles may weaken and atrophy
o Metabolic rate is raised, resulting in health and skin that is warm and moist
o Feeling Hot + Heat intolerance
o Appetit is increased but fails to match metabolic rate resulting in weight loss
o All of these signs are referred to as thyrotoxicosis
o Also usually present with exophthalmos - bulging of the eyes
Thyroid Characterized by profound hyperthermia (105 degrees F or higher), severe
o Treatment tachycardia, restlessness, agitation, and tremor.
Unconsciousness, coma, hypotension, and heart failure may ensure.
Treatment of thyroid storm? These symptoms are produced by excessive levels of thyroid hormone
Thyroid crisis can be life threatening and requires immediate treatment.
o High doses of potassium iodide or strong iodine solution are given to
suppress thyroid hormone release.
o Methimazole is given to suppress thyroid hormone synthesis
o A beta blocker is given to reduce heart rate
o Additional measures include sedation, cooling, and giving
glucocorticoids and IVF
Thyroid Can result in permanent neuropsychological deficits in the child - decrease child's
o Treatment IQ
The effect of hypothyroidism is limited largely to the first trimester, a time during
Result of not treating hypothyroidism during pregnancy? which the fetus is unable to produce thyroid hormone of its own
Some authorities currently recommend routine screening for hypothyroidism as
soon as pregnancy is confirmed
Women already taking thyroid hormone replacement will need to increase
dose by 50% max between weeks 4-8 of gestation and the levels will level out by
week 16
Thyroid Methimazole - first line drug of choice (not given to women who are pregnant or
o Treatment breastfeeding)
o Methimazole blocks synthesis of thyroid hormone.
Medication to treat symptoms of hyperthyroidism (notice 1) Prevents the oxidation of iodine, therefore inhibiting incorporation of
this is treating symptoms and not the hyperthyroidism iodine into tyrosine.
itself) 2)prevents iodinated tyrosine from coupling
Propylthiouracil - preferred treatment for thyroid storm
Beta blockers - help with tachycardia experienced with hyperthyroidism
NR 565 Final Study Guide
WEEK 5 ...
Thyroid -TSH - used primarily for screening and diagnosing hypothyroid and for
o Diagnosis & Evaluation monitoring replacement therapy in hypothyroid patients
What labs are used to diagnose? -T4 - Used to monitor thyroid hormone replacement therapy and to screen for
thyroid dysfunction
-T3 - Useful in the diagnosis of hyperthyroidism; can also be used to monitor
hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Thyroid Recheck TSH 6-8 weeks after initiating therapy and after any dosage change;
o Diagnosis & Evaluation Check TSH at least once a year after serum TSH is stabilized
Timeframe for re-check of labs after starting
levothyroxine?
, Thyroid Hypothyroidism: Depend on severity.
o Diagnosis & Evaluation o Mild: subtle and may go unrecognized
o Moderate to severe:
Signs and symptoms of hypothyroidism? -Face is pale, puffy, and expressionless.
-Skin cold and dry.
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
-Patient may complain of lethargy, fatigue, and
-Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if reduced levels of T3
and T4
Mentation may be impaired.
Thyroid o Elevated Heart rate and strong, and dysrhythmias and angina may develop
o Diagnosis & Evaluation o The CNS is stimulated, resulting is nervousness, insomnia, rapid thought flow,
and rapid speech, hyperreflexia, tremors
Signs and symptoms of hyperthyroidism? o Skeletal muscles may weaken and atrophy
o Metabolic rate is raised, resulting in health and skin that is warm and moist
o Feeling Hot + Heat intolerance
o Appetit is increased but fails to match metabolic rate resulting in weight loss
o All of these signs are referred to as thyrotoxicosis
o Also usually present with exophthalmos - bulging of the eyes
Thyroid Characterized by profound hyperthermia (105 degrees F or higher), severe
o Treatment tachycardia, restlessness, agitation, and tremor.
Unconsciousness, coma, hypotension, and heart failure may ensure.
Treatment of thyroid storm? These symptoms are produced by excessive levels of thyroid hormone
Thyroid crisis can be life threatening and requires immediate treatment.
o High doses of potassium iodide or strong iodine solution are given to
suppress thyroid hormone release.
o Methimazole is given to suppress thyroid hormone synthesis
o A beta blocker is given to reduce heart rate
o Additional measures include sedation, cooling, and giving
glucocorticoids and IVF
Thyroid Can result in permanent neuropsychological deficits in the child - decrease child's
o Treatment IQ
The effect of hypothyroidism is limited largely to the first trimester, a time during
Result of not treating hypothyroidism during pregnancy? which the fetus is unable to produce thyroid hormone of its own
Some authorities currently recommend routine screening for hypothyroidism as
soon as pregnancy is confirmed
Women already taking thyroid hormone replacement will need to increase
dose by 50% max between weeks 4-8 of gestation and the levels will level out by
week 16
Thyroid Methimazole - first line drug of choice (not given to women who are pregnant or
o Treatment breastfeeding)
o Methimazole blocks synthesis of thyroid hormone.
Medication to treat symptoms of hyperthyroidism (notice 1) Prevents the oxidation of iodine, therefore inhibiting incorporation of
this is treating symptoms and not the hyperthyroidism iodine into tyrosine.
itself) 2)prevents iodinated tyrosine from coupling
Propylthiouracil - preferred treatment for thyroid storm
Beta blockers - help with tachycardia experienced with hyperthyroidism
