Hondros NURS 212 Exam 3

subclinical hyperthyroidism lab values – TSH below 0.4 T3 and T4 normal overt hyperthyroidism labs – no TSH elevated T3 and T4 graves disease is a common form of hyperthyroidism. it can destruct the thyroid tissue, which can lead to - hypothyroidism skin/hair/nails for a hyperactive thyroid pt - warm, smooth, moist THIN brittle nails patchy hair loss with fine silky hair clubbing of fingers skin/hair/nails for hypoactive thyroid patient - dry, thick, inelsastic cold skin THICK, brittle nails dry, sparse, coarse hair puffy face decreased sweating pale TPO - measured to assess for thyroiditis Hashimotos lab values - thyroid hormones = low TSH = high complications of hyperthyroidism - thyrotoxicosis (aka thyrotoxic crisis aka thyroid storm) thyroid storm s/s - severe tachycardia HF shock hyperthermia (106) abdm pain N/V/D agitation delirium seizures what is used to detect between graves disease and thyroiditis - RAIU graves will have an uptake, thyroiditis will not care for hyperthyroid - managing resp distress reducing fever replacing fluid eliminating stressors drugs used for hyperthyroidism - antithyroid drugs (PTU and Tapazole) beta blockers iodine Propylthiouracil - pts who are pregnant first trimester, had adverse reaction to tapazole first line therapy for thyrotoxicosis (thyroid storm) taken three times a day hyperthyroid labs - low TSH (below 0.4) high T4 when is iodine given for pts with hyperthyrpid - before surgery and during thyrotoxicosis given with liquid, sipped through a straw to avoid orange staining - given after meals iodine toxicity - excessive salivation swelling of buccal mucosa and other membranes nausea, vomiting skin reactions Beta blockers and hyperthyroidism - given to decrease symptoms - tachy, nervous, irritablility, tremors propanolol with antithyroid agents atenolol for asthma or heart disease pts RAI therapy - do a pregnancy test before therapy can result in hypothyroidism can cause dry/irritated mouth delayed response (3 mo) so antithyroid and bblock initially teaching for RAI therapy - 1. private toilet and flush two-3 times 2. laundry, towels, bed linens wash separately from fam 3. dont prepare food that requires using your bare hands 4. avoid being close to pregnant pts for 7 days diet for hyperthyroid patients - a day avoid highlyseasoned and high fiber food avoid caffeine what does tapazole, PTU, iodine, and beta blockers do - blocks thyroid hormone production and beta blockers block sympathetic nervous system after administering meds for thyroid storm what are other interventions - cool room away from critically ill pts and noisy traffic light bed coverins and changing frequently if sweating help with rom to releive nerv sys tension interventions for exophthalmos (common for graves disease) - artificial tears to prevent corneal eye injury sit them up as much as possible glasses/tape eyes shut rom for eyeballs what should readily be available in a pts room after thyroid surgery - O2 suction equipment tracheostomy tray post op comp after thyroid surgery - hypothyroidism damage to parathyroid = hypoparathyroid and hypocalcemia thyrotoxicosis infection laryngeal nerve damage