Thyroid and Parathyroid
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54 terms
Terms | Definitions |
|---|---|
 Thyroid | butterfly shaped organ entirely vascular, controll metabolic activity and heart rate |
| TSH | A thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland problems, TSH causes the thyroid gland to make two hormone T4 and T3 |
| T4 T3 | are needed for normal growth of the brain, especially during the first 3 years of life. A baby whose thyroid gland does not make enough thyroid hormone (congenital hypothyroidism) may, in severe cases, be mentally retarded. Older children also need thyroid hormones to grow and develop normally. |
| calcitronin | controls high level of calcium that normally gets deposited into the bone |
| when calcium starts leaving the bone and going into the blood | the person could get arrythmias and die |
| over secretion of the thyroid hormone | cause hyper thyroid, enlarged thyroid gland is a goiter |
| goiters can also occur | with iodine deficiency happens in 3rd world countries |
| assessment | physical exam drink water, dr. stands behind you and palpatates your thryroid |
| TSH | low TSH has an inverse proportion means you have hyperthyroidism common between 20-40 genetics |
| TSH levels | .5 - 5.0 |
| greater than 5.0 means | hypothyroidism |
| Graves Disease | most common |
| Hashimoto Thyroiditis | is an autoimmune disease, a disorder in which the immune system turns against the body's own tissues. In people with Hashimoto's, the immune system attacks the thyroid. This can lead to hypothyroidism, a condition in which the thyroid does not make enough hormones for the body's needs |
| Thyroid Storm | suuden surge of lg. amounts of thyroid hormone into bloodstreams causing a med. emergency with high mortality rate. Hyperthermia, hypertension, delirium, vomiting, diarrhea, ab. pain, tachydysrthymmias Maintain patent airway, monitor for dysrthmmias.admin. acetaminophen, cool sponge baths, give PTU and Inderal, O2 |
| Nurses response to Thyroid Storm | maintain a patent airway, monitor for dysrthymias, give analgesic, cool sponge bath, ad. PTU and Tapazole, O2 |
| Diag for thyroid disease | pt. is given a tracer dose of radioactive iodine test |
| Check to see if patient had taken any iodine medications | cough syrup, amnioterol, steroids, chemotherapy amphetamines |
| fine needle aspiration biopsy done when | a malignancy of a thyroid tumor is suspected |
| Graves disease | pt. is actually give high dose of iodine which cause them then to become hypothryoid it burns out the thryroid |
| Hypothyroidism most common is | hashimoto thryoiditis, post graves disease |
| Thyroidectomy | removal of thyroid, especially if airway issues, keep trachea at bedside |
| Hypothryroidism can be caused by | radiation treatment |
| symptoms of hypothyroid | fatigue, hair loss, dry skin, husky voice, menorrhagia, subnormal temp., body rate comes down, increased wt., mask like face, accumulation of polysaccharides, cold, irritable, speak slow, tongue enlarges, constipation |
| myxedema coma | severe bradycardia, decrease cardiac output, stupor, hypotension Maintain airway, fluid replacement, warm with blankets, give IV levothyroxine |
| hypo. post op complications | at risk for heart failure, bradycardia, |
| whos at risk | elderly women |
| graves | is younger |
| all pt. with hypo thryroid | special attention should be paid to administration of analgesics, slower to clear the body, impaired renal funct. |
| Levothyroxine | thyroid hormone for hypothryroidism |
| hypothyroid patients at risk for developing | coronary artery disease |
| nursing diag for hypothyroid | imbalanced body temperature, know. deficit |
| hyperthyroidism | affects women 8x's more, occurs after emmotional shock, trauma, younger woman's disease,afib high corr. |
| Signs and symptoms of hyperthryroidism | nervousness, irritable, emotional excitability, fine tremors, expothalmus (eyes bulge) wt. loss, afib, more freq. bowels |
| thyroid storm | crisis of uncontrolled hyperthyroidism caused by the release into the bloodstream of increased amount of thyroid hormone; also called thyroid crisis or thyrotoxic crisis, exacerbation, wt. loss, tachycardia, palpitations |
| Treatment for Hyperthyroidism | surgery, antithyroid med. , or radioactive iodine The anti thyroid med. is Tapazole or PTU |
| radio active iodine induces | hypothermia, to obliterate thyroid, give supplement |
| PTU | rash nausea, lupus like syndrome |
| Inderal po | beta blocker for tachycardia |
| Graves symptoms | Weight loss despite increased appetite Faster heart rate, higher blood pressure, and increased nervousness Excessive perspiration Increased sensitivity to heat More frequent bowel movements Muscle weakness, trembling hands Development of a goiter (enlargement of the thyroid gland, causing a swelling at the base of the neck)., bulging eyes |
| Parathyroid | 4 glands situated in the neck and embedded in the posterior aspect of the thyroid gland |
| Parathormone regulates | calcium and phosphorus |
| Increased secretion of parathormone | causes more caliciun to enter the blood whcih may be life thereatening and depletes the bones of calcium |
| too much parathormone can also cause | renal calcification occurs in patients with renal failure |
| Symptoms of excessive parathormone | may be asymptomatic, apathy, fever, muscle weakness, vomiting, constipation, hyptertension, dysrhthmias |
| Clinical manifestation | over secretion of parathormone causes kidney stones demineralization of bone, skeletal pain and fractures increase in peptic ulcers and pancreatitis |
| Dx of excess Parathormone | elevation of calcium serum, bone changes on x ray, |
| For Primary hyperParathyroidism | take out partial glands |
| Nursing Intervention for hyperParathyroidism | give increase fluids to 2 liters per day cranberry juice avoid thiazide diuretic, diet w/o calcium |
| Hypercalcemic Crisis | ICU, extreme serum calcium elevation greater than 15, result is neurological, renal and cardiovascular Sx, treat with lg amounts of fluids and lasix, phosphate therapy, dialysis, Calcitonin |
| Hypocalcemia | irritable, tetany, tremors, may lead to largyngeal spasm, seizures, dysrthymias, spasms with blood press. |
| Chvostek's sign | sharp tap of facial nerve causes spasms of mouth |
| Treat Hypocalcemia | with IV calcium gluconate, IV parathormone goal to increase calcium to 9 or 10 |
| Chronic treatment for Hypocalcemia | restrict milk and eggs because they have phosporous, avoid spinach, give oral calcium salts after meals to bind phos. |
| Signs of hypocalcemia | tingling of fingers and toes Have calcium gluconate available, maintain seizure precautions |
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