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NR 565 - Final (week 5) exam with 100- correct answers
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NR 565 - Final (week 5) exam with 100- correct answers
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NR 565 - Final (week 5) exam with100% correct answers
Thyroid panels - answer diagnosis comes from TSH, total T4 and T3,
free T4 and T3
Recheck Thyroid labs - answer 6-8 weeks after starting therapy.
Hypothyroidism - answer pale, puffy, expressionless. cold & dry
skin, brittle hair with hair loss, lethargy, fatigue, intolerance to cold.
mentation may be impaired. Thyroid enlargement if decreased
levels of T3 and T4 which promote excessive release of TSH.
Hyperthroidism - answer heartbeat is rapid and strong, dysrhythmia
and angina possible. nervousness, insomnia, rapid thought flow and
speech, muscle weakness and atrophy. increase metabolic rate,
intolerance to heat, skin warm and moist, increased appetite but
weight loss
thyrotoxicosis - answer condition caused by excessive thyroid
hormones - all symptoms
graves disease - answer exophthalmos.
treatment of thyroid storm - answer high dose potassium iodine or
strong iodine solution to suppress thyroid hormone release.,
methimazole to suppress thyroid hormone synthesis, beta blocker to
reduce heart rate, sedation cooling glucocorticoids and IV fluids.
not treating hypothyroidism during pregnancy - answer permanent
neurological defects, decreased IQ, large protruding tongue,
, potbelly dwarfish stature, impaired development of nervous system,
bones, teeth, and muscles.
medication to treat symptoms of hyperthyroidism - answer *treats
symptoms and not the hyperthyroidism itself.
beta blockers (metoprolol) to treat tachycardia
Absorption of levothyroxine REDUCED by: - answer histamine 2
receptor blockers (tagamet), proton pump inhibitors (lansoprazole),
sucralfate (carafate), Cholestyramine (Questran), Colestipol
(colestid), aluminum containing antacids (mylanta, maalox), calcium
supplements (tums), iron supplements, magnesium salts, orlistat.
*4 hours between levothyroxine and the above meds is
recommended as well as food
Metabolism of levothyroxine ACCELERATED by: - answer phenytoin
(dilantin), Carbamazepine (Tegratol, Caratrol), Rifampin (Rifadin),
Sertraline (Zoloft), Phenobarbital.
*patients taking these medications will need to have dose of
levothyroxine increased.
Warfarin & Levothyroxine - answer levothyroxine accelerates
degradation of vitamin k dependent clotting factors, may need to
reduce the dose of warfarin.
Catecholamines - answer increase cardiac responsiveness - at an
increased risk of catecholamine induced dysrhythmia.
Digoxin and insulin - may need to be increased if pt. is taking
levothyroxine.
How to confirm diagnosis of diabetes - answer Hemoglobin A1C >
6.5 %
Fasting plasma glucose > 126 mg/dL
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