chapter 18 thyroid emergencies
euthyroid
is the term used to describe an individual with a normally functioning thyroid gland
the action of the thyroid gland?
is to produce thyroid hormones. Is a threefold; metabolic rate, growth rate, and other specific body mechanisms.
patients with hypothyroidism should be asked the following?
- are they taking their medications? -is their dosage stabilized? -do they have routine blood work performed to insure adequate medication levels?
patients with hypothyroidism are continually medicated with a synthetic thyroid hormone. this medication is some form of?
levothyroxine
the most common medication a patient would take for hypothyroidism is?
levothyroxine
the emergent condition arising from severe hypothyroidism is?
myxedema coma
signs and symptoms of myxedema coma?
-deterioration of the patient's mental state; confusion, apathy, depression, or psychosis -hypothermia (temp <95) -hair loss -certain facial conditions; puffiness, macroglossia, ptosis, periorbital edema -cool dry skin with non pitting edema -bradycardia -changes in blood pressure -constipation -seizures -impaired mobility -hypoventilation -coma, which is rare
signs and symptoms of thyroid storm?
-fever (possibly as high as 108) -diaphoresis -restlessness -confusion -anxiety -psychosis -gastrointestinal symptoms; nausea, vomiting, diarrhea, jaundice -increased systolic blood pressure -tachycardia -widened pulse pressure -arrhythmias
ablation therapy
A treatment for hyperthyroidism using radioactive iodine to disable the thyroid. this will cause the patient to be hypothyroid and he or she will need to be medicated with a synthetic hormone replacement.
the most accepted method for treating hyperthyroidism is?
ablation therapy
all of the following are treatment management strategies for myxedema coma except? -slowly rewarming the patient -administering IV levothyroxine -administering IV corticosteroids -administering sedatives and tranquilizers
administering sedatives and tranquilizers; should not be used as it will increase the risk of respiratory arrest
side effects from antithyroid medications?
agranulocytosis and hepatitis
myxedema
caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism
hypothyroidism is characterized by? -weight loss -cold intolerance -diarrhea -low cholesterol
cold intolerance
thyrotoxicosis is also known
condition caused by excessive thyroid hormones and is often the result of a condition called graves disease
ptosis
falling
which of the following is a sign of thyroid storm? -fever -macroglossia -bradycardia -hypoventilation
fever
the hereditary autoimmune disorder whereby the individual has an increased level of thyroid hormone production is known as
graves disease
thyroid storm
if thyroid hormone levels become too high, the patient will most likely experience a serious condition
causes of hypothyroidism or myxedema?
include autoimmune disorders, such as hashimoto's thyroiditis, pituitary tumors, surgery, or irradiation
hypothyroidism or myxedema
insufficient thyroid hormone is produced by the thyroid gland
thyroid gland
is a butterfly shaped organ that is located anterior to the trachea.
graves disease
is a disorder associated with an enlarged thyroid gland, which will feel soft on palpation. the origin in unknown, but the disease is hereditary in nature and is suspected to be an autoimmune disorder.
nodular goiter
is an enlarged thyroid gland with multiple nodules. may become toxic and produced thyroid hormone on its own causing hyperthyroidism.
hyperthyroid patients are treated in one of three ways?
surgery, ablation therapy, or antithyroid drugs
hyperthyroidism
too much thyroid hormone is produced by the thyroid gland
Hyperthyroidism signs and symptoms?
weight loss, nervousness, insomnia, bulging eyes (exophthalmos), tremors, increased sweating, rapid heart rate, and diarrhea.
myxedea coma
when thyroid hormone levels become to low, the patient may experience a potentially life-threatening condition
all of the following are strategies for managing thyroid storm except one? -wrapping in blankets to increase body temperature -administering oxygen 4-6 liters minute -administering acetaminophen -administering beta-blockerfs
wrapping in blankets to increase body temperature
hypothyroidism signs and symptoms?
young individuals; cold intolerance, weight gain, dry skin, constipation, and mental and physical slowing. ederley; same symptoms may apply; however may be difficult to decipher because they have other chronic diseases