Med surg 201 intermediate Week 6 quiz 5

Med surg intermediate Week 6 quiz 5 Breathing Heart rate Central and peripheral nervous systems Body weight Muscle strength Menstrual cycles› Body temperature Cholesterol levels ans: The thyroid's hormones regulate vital body functions, including: Hyperthyroidism ans: Hyperactivity of the thyroid gland is called? thyroid hormones ans: Hyperthyroidism is an increase in synthesis and release of women ans: does hyperthyroidism occur more in women or men? 20-40 years ans: what is the age of the highest frequency for hyperthyroidism ? Graves disease ans: what is the most common form of hyperthyroidism? Toxic nodular goiter Thyroiditis Excess iodine intake Pituitary tumors Thyroid cancer ans: what are other causes of hyperthyroidism insufficient iodine infection stress ans: what precipitating factors of hyperthyroidism interact with genetic factors? 5 ans: Women are ______ times more likely than men to develop Graves' disease hyperthyroidism ans: characterized by remissions and exacerbations Increased metabolism Increased tissue sensitivity to stimulation by SNS ans: hyperthyroidism clinical manifestation Ophthalmopathy ans: abnormal eye appearance or function; hyperthyroidism clinical manifestation Exophthalmos ans: Increased fat deposits and fluid Eyeballs faced outward Hyperthyroidism manifestation Goiter ans: When the thyroid gland is excessively large, a ___________ may be noted on inspection. Bruits ans: Auscultating the thyroid gland may reveal _________, a reflection of increased blood supply. Increased rate and force of contractions Increased CO Systolic htn ans: Cardio manifestation of hyperthyroidism Dyspnea on mild exertion Increased RR ans: respiratory manifestation of hyperthyroidism Hair loss Warm, smooth, moist skin Thin brittle nails ans: Integumentary manifestations of hyperthyroidism Increased appetite and thirst Weight loss Diarrhea ans: GI manifestations hyperthyroidism hepatomegaly ans: what happens to the liver with hyperthyroidism? Nervousness Fine tremors Insomnia Inability to concentrate Changes in mood ans: Nervous system hyperthyroidism manifestations Fatigue Weakness Proximal muscle wasting ans: Musculoskeletal hyperthyroidism manifestations Thyrotoxic Crisis (Thyroid Storm/acute thyrotoxicosis) ans: life threatening emergency caused by stressors that occurs with hyperthyroidism Thyrotoxic Crisis (Thyroid Storm/acute thyrotoxicosis) ans: what is it called when an excessive amounts of hormones are released? Severe tachycardia, heart failure Shock Hyperthermia Fever up to 106 (41.1º C) Agitation Seizures Abdominal pain, vomiting, diarrhea Delirium, coma ans: thyroid storm manifestations Meds to block thyroid hormone production and SNS Monitoring for dysrhythmias Adequate oxygen Fluid and Electrolyte replacement ans: Nursing implementations for thyroid storm decreased TSH, increased T3, T4 Radioactive iodine uptake ans: how to test for hyperthyroidism? Block adverse effects of thyroid hormones Suppress hormone oversecretion Prevent complications ans: interprofessional goals for hyperthyroidism Antithyroid medications Radioactive iodine therapy (RAI) Surgery ans: three primary treatment optioms for hyperthyroidism antithyroid drugs iodine beta blockers ans: What drugs are not considered curative for hyperthyroidism? Propylthiouracil (PTU) Methimazole (Tapazole) ans: 2 anti-thyroid drugs? antithyroid drugs ans: inhibits synthesis of thyroid hormone 1-2 weeks ans: how long does improvement take with anti thyroid drugs 4-8 weeks ans: how long does it take for good results to occur with anti-thyroid drugs 6-15 months ans: how long is anti-thyroid therapy adhere to medication drug regimen ans: patient teaching with anti-thyroid drugs? Iodine ans: inhibits synthesis of T3 and T4 and block their release into circulation Iodine ans: decreases vascularity of thyroid gland 1-2 weeks ans: how long does it take for iodine to reach its maximum effect? Iodine ans: used before surgery and to treat crisis Propranolol (Inderal) Atenolol (Tenormin) ans: 2 B adrenergic Blockers B adrenergic blockers ans: Block effects of sympathetic nervous stimulation B adrenergic blockers ans: Causes symptomatic relief of thyrotoxicosis Radioactive Iodine Therapy (RAI) ans: Treatment of choice in nonpregnant adults Damages or destroys thyroid tissue Delayed response of up to 3 months Treated with antithyroid drugs and β-blocker before and during first 3 months of RAI Given on outpatient basis Patient teaching for Radio active therapy ans: Oral care for thyroiditis/parotiditis Radiation precautions Symptoms of hypothyroidism indications for surgical therapy ans: Large goiter causing tracheal compression Unresponsive to antithyroid therapy Thyroid cancer Not a candidate for Radioactive Iodine Therapy subtotal thyroidectomy ans: what surgical therapy involves the removal of 90% of thyroid? Hypocalcemia Hemorrhage Laryngeal nerve damage Thyrotoxic crisis Infection ans: what complications should the nurse monitor for a hyperthyroid patient laryngeal stridor ans: when monitoring the patients for a patent airway what should be included within the monitoring? Q 2 hours during first 24 hours ans: how often should you assess the patient after subtotal thyroidectomy Semi Fowlers ans: what position should the patient be in after subtotal thyroidectomy Support head with pillows Avoid neck flexion and tension on suture line ans: nurse implementation for post op subtotal thyroidectomy high calorie diet (/day) 6 full meals a day w snacks in between increase carb intake ans: what type of diet should a patient with hyperthyroidism be on? 1-2 g/kg ans: how much protein should a patient with hyperthyroidism be on? highly seasoned foods high fiber foods caffeine ans: what should a patient with hyperthyroidism avoid? D ans: The nurse is caring for a patient who just returned to the surgical unit following a thyroidectomy. The nurse is most concerned if which is observed? A) The patient complains of increased thirst. B) The patient reports a sore throat when swallowing. C) The patient supports her head when moving in bed. D) The patient makes harsh, vibratory sounds when breathing. Hypothyroidism ans: causes general slowing metabolic rate Primary hypothyroidism ans: Caused by destruction of thyroid tissue or defective hormone synthesis Secondary hypothyroidism ans: Caused by pituitary or hypothalamic dysfunction (↓ TSH or TRH) Iodine deficiency Atrophy of the gland Treatment for hyperthyroidism Cretinism if occurs in infancy ans: what causes hypothyroidism? Amiodarone Lithium ans: what drugs cause hypothyroidism Dry, thick, inelastic, cold skin Thick, brittle nails Dry, sparse, coarse hair Poor turgor of mucosa Generalized interstitial edema Puffy face Decreased sweating Pallor ans: Integumentary hypothyroidism clinical manifestations Decreased Cardiac contractility & output Increased Serum cholesterol & triglycerides ans: Cardiovascular hypothyroidism clinical manifestations Low exercise tolerance Shortness of breath on exertion ans: Respiratory hypothyroidism clinical manifestations Fatigue, lethargy Mood changes Impaired memory Slowed speech ans: Neurologic hypothyroidism clinical manifestations Decreased appetite N/V Weight gain Constipation Distended ABD ans: GI hypothyroidism clinical manifestations Fatigue Weakness Muscular aches and pains Slow movements Arthraligia ans: Musculoskeletal hypothyroidism clinical manifestations Prolonged menstrual periods or amenorrhea Decreased libido, infertility ans: Reproduction system hypothyroidism clinical manifestations Increased susceptibility to infection Increased sensitivity to opioids, barbiturates, anesthesia Intolerance to cold Decreased hearing Sleepiness Goiter ans: OTHER hypothyroidism clinical manifestations myxedema ans: Patients with severe long-standing hypothyroidism may display __________________ which is the physical appearance of the skin and subcutaneous tissues. infection drugs cold trauma ans: myxedema coma is percipitated by? Impaired consciousness Subnormal temperature, hypotension, hypoventilation Cardiovascular collapse ans: myxedema coma is characterized by Mechanical respiratory support Cardiac monitoring IV thyroid hormone replacement Monitoring of care temperature ans: Myxedema coma necessitates acute care Hypothyroidism diagnostic studies ans: History and physical examination TSH and free T4 TSH ↑ with primary hypothyroidism (defect in thyroid) TSH ↓ with secondary hypothyroidism (defect in pituitary or hypothalamus Thyroid antibodies : autoimmune in origin ↑ Cholesterol ↑ Triglycerides ↑ Creatine kinase (hypothyroid myopathy) ↓ RBCs (anemia): due to decreased erythropoietin production Levothyroxine (Synthroid) ans: what med to give with hypothyroidism 4-6 weeks ans: when to increase the Levothyroxine (Synthroid) dose Thyroid medicine in morning on empty stomach Life long therapy ans: patient teaching with hypothyroidism weight loss increased appetite ans: side effects of Levothyroxine (Synthroid) crushing syndrome addisons disease ans: disorders of adrenal cortex crushing syndrome ans: Caused by excess of corticosteroids