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NR566 Chapter 41 complete study guide

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Course
AIT Nursing (NR566)

Institution
Thompson River University (TRU )

 Clinical signs & symptoms, risk factors, associated symptoms, and diagnosis o HYPERTHYROIDISM (Thyrotoxicosis)  Grave’s disease- common etiology of hyperthyroidism  Autoimmune disease characterized by generation of abnormal IgG autoantibodies to thyroid peroxidase and thyroglobin -&g...

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risk factors
associated symptoms
o hypot
chapter 41 hyperthyroidism and hypothyroidism
nr566 chapter 41 study guide
 clinical signs amp symptoms
and diagnosis o hyperthyroidism thyrotoxicosis

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Chapter 41: HYPERTHYROIDISM and HYPOTHYROIDISM

 Clinical signs & symptoms, risk factors, associated symptoms, and diagnosis
o HYPERTHYROIDISM (Thyrotoxicosis)
 Grave’s disease- common etiology of hyperthyroidism
 Autoimmune disease characterized by generation of abnormal IgG
autoantibodies to thyroid peroxidase and thyroglobin -> binds to the
TSH receptors -> activating excessive glandular growth and hormone
production.
 S/Sx:
 heat intolerance
 heightened sensitivity to SNS stimulation
 nervousness
 irritability
 palpitations
 tremors
 increased heart rate
 low TSH and TRH, increased iodine reuptake
 goiter- enlargement of thyroid gland
 disproportionate increased T3 production- HALLMARK of long-term
overstimulation of the gland.
 Risk Factors:
 DM
 Pernicious anemia
 Primary adrenal insufficiency
 Vitiligo
 Leukotrichia (prematurely gray hair)
 Vitiligo
 Drug compounds that contain iodine or affect iodine metabolism
 Viruses and pregnancy (can trigger thyroiditis)
 Diagnosis:
 Low TSH, High T3 and T4 = primary hyperthyroidism
 Low TSH, normal T3 and T4 = subclinical hyperthyroidism

, o HYPOTHYROIDISM
 Primary:
 defective hormone synthesis resulting from autoimmune thyroiditis,
endemic iron deficiency, or antithyroid drugs that were used to treat
hyperthyroidism
 congenital defects or loss of tissue after treatment for hyperthyroidism
 decreased thyroid hormone level -> hypothalamus -> increased TRH ->
increased TSH -> stimulates thyroid gland enlargement
 Hashimoto’s thyroiditis- immune related disorder in which all
components of thyroid gland are injured, but especially the TSH
receptors.
 Subacute thyroiditis- an inflammation of the thyroid often preceded by
a viral infection.
 Congenital hypothyroidism- occurs in infants as a result of absent
thyroid tissue and hereditary defects in thyroid hormone synthesis

 Secondary (less common):
 Conditions that cause either pituitary or hypothalamic failure
 TSH response is inadequate so that the gland is normal or reduced in
size, with both T3 and T4 synthesis equally reduced.

 S/Sx:
 Low basal metabolic rate
 Cold intolerance
 Lethargy
 Slightly lowered body temperature
 Myxedema (occurs in long-standing untreated hypothyroidism, sign of
severe hypothyroidism)
 Pitting, boggy edema
 Around the eyes
 Hands
 Shins
 Supraclavicular fossae
 Thickening of the tongue
 Thickening of the laryngeal-pharyngeal membranes (thick,
slurred speech, hoarseness)
 Risk Factors:
 Primarily occurs in women older than 50yo
 Family hx of thyroid disease or autoimmune disease
 Type 1 DM
 Rheumatoid arthritis
 Currently taking anti-thyroid medications
 Treated with radioactive iodine for thyroid cancer
 Thyroid surgery
 Radiation exposure to neck or upper chest area

 Diagnosis:
 High TSH, low T3 and T4

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