Exam 2 - Adult Health 2 NSG 4413
Chapter 45
● Hypothyroidism labs
○ High TSH, Low Free T3 & Free T4
● - Diabetes insipidus confirmation test
○ Diabetes Insipidus: condition in which abnormally large volumes of dilute urine
are excreted as a result of deficient production of vasopressin
○ Due to injury to the hypothalamus or pituitary gland with a deficiency of ADH
(vasopressin) that results in excretion of large volumes of dilute urine and
extreme thirst. DI is characterized as central, nephrogenic, or dipsogenic, as well
as gestational
○ The fluid deprivation test is carried out by withholding fluids for 8 to 12 hours or
until 3% to 5% of the body weight is lost.
○ The patient is weighed frequently during the test. Plasma and urine osmolality
studies are performed at the beginning and end of the test.
○ The inability to increase the specific gravity and osmolality of the urine is
characteristic of DI.
● Treatment for hypothyroidism
○ Prescription: Levothyroxine (synthroid) ; The general range is 75 to 150 mcg per
day and treatment is generally started at the lower dose and titrated slowly until
desired levels of serum TSH concentration are achieved
● Thyroidectomy post op emergency equipment
○ Priorities are to observe for any difficulty in breathing due to edema of the glottis,
hematoma formation, or injury to the recurrent laryngeal nerve which requires the
insertion of an airway, and to monitor the pulse and blood pressure for any
indication of internal bleeding.
○ A tracheostomy set is kept at the bedside at all times, along with oxygen for any
respiratory distress.
○ IV fluids are given immediately after, IV calcium glutamate is on hand for tetany in
the muscles.
● Levothyroxine teaching
○ Given at the start of the day, before meals on an empty stomach (30m AC)
● - Chvostek and Trousseau’s Sign
○ Chvostek sign: Tapping over facial nerve over parotid gland causing twitching
○ Trousseau sign: Carpopedal spasm with BP cuff causing blood flow occlusion
● - SIADH Nursing priority
○ Syndrome of Inappropriate antidiuretic Hormone: excessive secretion of
antidiuretic hormone from the pituitary gland despite low serum osmolality level
○ Fluid & electrolyte monitoring
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, ○ Close monitoring of fluid I&O, daily weight, urine and blood chemistries, and
neurologic status
● - Importance of tapering prednisone
○ Tapered (reduced gradually) to allow normal adrenal function to return and to
prevent steroid-induced adrenal insufficiency
● - Methimazole (antithyroid drug)
○ Given with Thyroid Storm
○ Given to impede formation of thyroid hormone and block conversion of T4 to T3 ,
the more active form of thyroid hormone
○ Teratogenic
○ More toxic than propylthiouracil.
○ Watch for rash and other symptoms as for propylthiouracil
● - Grave’s disease s/s
○ autoimmune disorder that results from an excessive output of thyroid
hormones caused by abnormal stimulation of the thyroid gland by circulating
immunoglobulins
○ s/s: exophthalmos, fine hair, nervous, restless, emotionally unstable, insomnia,
goiter, tachycardic, palpitations, high cardiac output failure, increased appetite,
weight loss, muscle wasting, sweating/heat intolerance, fine tremors,
oligomenorrhea, pretibial myxedema
● - Thyroid storm s/s
○ Life-threatening condition of the thyroid due to untreated hyperthyroidism
○ s/s:Hyperpyrexia (high fever), >38.5°C (>101.3°F) Extreme tachycardia (>130
bpm) Exaggerated symptoms of hyperthyroidism with disturbances of a major
system—for example, gastrointestinal (weight loss, diarrhea, abdominal pain) or
cardiovascular (edema, chest pain, dyspnea, palpitations) Altered neurologic or
mental state, which frequently appears as delirium psychosis, somnolence, or
coma.
○ Usually precipitated by stress, such as injury, infection, thyroid and non thyroid
surgery, tooth extraction, insulin reaction, diabetic ketoacidosis, pregnancy,
digitalis intoxication, abrupt withdrawal of antithyroid medications, extreme
emotional stress, or vigorous palpation of the thyroid.
● - Cushing’s Disease nursing education , s/s
○ Excessive adrenocortical activity or corticosteroid prescriptions
○ s/s: Hyperglycemia, central obesity with buffalo hump, heavy trunk, thin
extremities, fragile thin skin, Kyphosis, backache, and compression fractures of
the vertebrae, ecchymosis, “moon face”, striae, weight gain
○ Nursing education: Maintain regular exercise with weight bearing;
● - Addison Crisis and treatment
○ acute adrenocortical insufficiency; characterized by hypotension, cyanosis, fever,
nausea/vomiting, and signs of shock
○ If Addisonian crisis occurs, the patient is treated for circulatory collapse and
shock
● - Hyperthyroidism nursing interventions (comfort measures) and s/s
This study source was downloaded by 100000900412927 from CourseHero.com on 12-16-2025 18:19:48 GMT -06:00
https://www.coursehero.com/file/251579176/NSG-4413-AH2-Exam-2pdf/
Chapter 45
● Hypothyroidism labs
○ High TSH, Low Free T3 & Free T4
● - Diabetes insipidus confirmation test
○ Diabetes Insipidus: condition in which abnormally large volumes of dilute urine
are excreted as a result of deficient production of vasopressin
○ Due to injury to the hypothalamus or pituitary gland with a deficiency of ADH
(vasopressin) that results in excretion of large volumes of dilute urine and
extreme thirst. DI is characterized as central, nephrogenic, or dipsogenic, as well
as gestational
○ The fluid deprivation test is carried out by withholding fluids for 8 to 12 hours or
until 3% to 5% of the body weight is lost.
○ The patient is weighed frequently during the test. Plasma and urine osmolality
studies are performed at the beginning and end of the test.
○ The inability to increase the specific gravity and osmolality of the urine is
characteristic of DI.
● Treatment for hypothyroidism
○ Prescription: Levothyroxine (synthroid) ; The general range is 75 to 150 mcg per
day and treatment is generally started at the lower dose and titrated slowly until
desired levels of serum TSH concentration are achieved
● Thyroidectomy post op emergency equipment
○ Priorities are to observe for any difficulty in breathing due to edema of the glottis,
hematoma formation, or injury to the recurrent laryngeal nerve which requires the
insertion of an airway, and to monitor the pulse and blood pressure for any
indication of internal bleeding.
○ A tracheostomy set is kept at the bedside at all times, along with oxygen for any
respiratory distress.
○ IV fluids are given immediately after, IV calcium glutamate is on hand for tetany in
the muscles.
● Levothyroxine teaching
○ Given at the start of the day, before meals on an empty stomach (30m AC)
● - Chvostek and Trousseau’s Sign
○ Chvostek sign: Tapping over facial nerve over parotid gland causing twitching
○ Trousseau sign: Carpopedal spasm with BP cuff causing blood flow occlusion
● - SIADH Nursing priority
○ Syndrome of Inappropriate antidiuretic Hormone: excessive secretion of
antidiuretic hormone from the pituitary gland despite low serum osmolality level
○ Fluid & electrolyte monitoring
This study source was downloaded by 100000900412927 from CourseHero.com on 12-16-2025 18:19:48 GMT -06:00
https://www.coursehero.com/file/251579176/NSG-4413-AH2-Exam-2pdf/
, ○ Close monitoring of fluid I&O, daily weight, urine and blood chemistries, and
neurologic status
● - Importance of tapering prednisone
○ Tapered (reduced gradually) to allow normal adrenal function to return and to
prevent steroid-induced adrenal insufficiency
● - Methimazole (antithyroid drug)
○ Given with Thyroid Storm
○ Given to impede formation of thyroid hormone and block conversion of T4 to T3 ,
the more active form of thyroid hormone
○ Teratogenic
○ More toxic than propylthiouracil.
○ Watch for rash and other symptoms as for propylthiouracil
● - Grave’s disease s/s
○ autoimmune disorder that results from an excessive output of thyroid
hormones caused by abnormal stimulation of the thyroid gland by circulating
immunoglobulins
○ s/s: exophthalmos, fine hair, nervous, restless, emotionally unstable, insomnia,
goiter, tachycardic, palpitations, high cardiac output failure, increased appetite,
weight loss, muscle wasting, sweating/heat intolerance, fine tremors,
oligomenorrhea, pretibial myxedema
● - Thyroid storm s/s
○ Life-threatening condition of the thyroid due to untreated hyperthyroidism
○ s/s:Hyperpyrexia (high fever), >38.5°C (>101.3°F) Extreme tachycardia (>130
bpm) Exaggerated symptoms of hyperthyroidism with disturbances of a major
system—for example, gastrointestinal (weight loss, diarrhea, abdominal pain) or
cardiovascular (edema, chest pain, dyspnea, palpitations) Altered neurologic or
mental state, which frequently appears as delirium psychosis, somnolence, or
coma.
○ Usually precipitated by stress, such as injury, infection, thyroid and non thyroid
surgery, tooth extraction, insulin reaction, diabetic ketoacidosis, pregnancy,
digitalis intoxication, abrupt withdrawal of antithyroid medications, extreme
emotional stress, or vigorous palpation of the thyroid.
● - Cushing’s Disease nursing education , s/s
○ Excessive adrenocortical activity or corticosteroid prescriptions
○ s/s: Hyperglycemia, central obesity with buffalo hump, heavy trunk, thin
extremities, fragile thin skin, Kyphosis, backache, and compression fractures of
the vertebrae, ecchymosis, “moon face”, striae, weight gain
○ Nursing education: Maintain regular exercise with weight bearing;
● - Addison Crisis and treatment
○ acute adrenocortical insufficiency; characterized by hypotension, cyanosis, fever,
nausea/vomiting, and signs of shock
○ If Addisonian crisis occurs, the patient is treated for circulatory collapse and
shock
● - Hyperthyroidism nursing interventions (comfort measures) and s/s
This study source was downloaded by 100000900412927 from CourseHero.com on 12-16-2025 18:19:48 GMT -06:00
https://www.coursehero.com/file/251579176/NSG-4413-AH2-Exam-2pdf/
