NR565 Final Exam Questions and Correct Answers the Latest Update and Recommended Version
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Course
NR565
Institution
NR565
What labs are used to diagnose thyroid function?
→ 1. Serum thyroid-stimulating hormone test (TSH)
→ 2. Serum thyroxine test (Total or Free T4)
→ 3. Serum triiodothyronine test (Total or Free T3)
s/s hypothyroidism
→ Signs and symptoms of hypothyroidism depend on disease severity. The ...
NR565 Final Exam Questions and Correct
Answers the Latest Update and
Recommended Version
What labs are used to diagnose thyroid function?
→ 1. Serum thyroid-stimulating hormone test (TSH)
→ 2. Serum thyroxine test (Total or Free T4)
→ 3. Serum triiodothyronine test (Total or Free T3)
s/s hypothyroidism
→ Signs and symptoms of hypothyroidism depend on disease severity. The face is pale,
puffy, and expressionless; skin is cold and dry; hair is brittle; hair loss occurs;Heart
rate and temperature are lowered. The patient may complain of lethargy, fatigue,
and intolerance to cold. Mentation may be impaired.
s/s hyperthyroidism
→ Exophthalmos; Heartbeat is rapid and strong; dysrhythmias and angina may develop;
nervousness; insomnia, rapid thought flow; rapid speech; Skeletal muscles may weaken
and atrophy; Metabolic rate is raised, resulting in increased heat production,
increased body temperature, intolerance to heat, and skin that is warm and moist.
Appetite is increased, but weight loss may still occur.
When should you re-check labs after initiating Levothyroxine?
→ TSH 6-8 weeks after initiation or dose changes.
S/S of Thyrotoxic Crisis (Thyroid Storm)
→ profound hyperthermia (105°F or even higher), severe tachycardia, restlessness,
agitation, and tremor. Unconsciousness, coma, hypotension, and heart failure may occur
→ *Excessive levels of thyroid hormones (occurs after surgery or intercurrent illness (e.g.
sepsis)
→ *MEDICAL EMERGENCY*
→ 1.High doses of potassium iodide or strong iodine solution are given to suppress
thyroid hormone release.
→ 2.Methimazole is given to suppress thyroid hormone synthesis. 3.A β-blocker is given to
reduce heart rate.
→
→ Additional measures include sedation, cooling, and giving glucocorticoids and IV fluids.
What can result from not treating hypothyroidism during pregnancy?
→ permanent neuropsychological deficits in the child
Treatment of hyperthyroidism
→ 1. surgical removal of thyroid tissue
→ 2. destruction of thyroid tissue with radioactive iodine (preferred for adults)
→ 3. antithyroid drug (methimazole or propylthiouracil). (preferred for younger patients)
→
→ β-Blockers suppress tachycardia by blocking β-receptors on the heart.
→ Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
→ Food decreases absorption. Should be taken on an empty stomach 30-60 minutes prior
to breakfast
Drugs that accelerate levothyroxine metabolism
→ phenytoin (Dilantin)
→ carbamazepine (Tegretol, Carbatrol)
→ rifampin (Rifadin)
→ sertraline (Zoloft)
→ phenobarbital.
→
→ *To maintain adequate levothyroxine levels, patients taking these drugs may need to
increase their levothyroxine dosage.
→
→ *Digoxin and Insulin may have more requirements when taking levothyroxine
Which laboratory tests should be completed before prescribing methimazole?
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