NUR 445 Exam 1 Endocrine UPDATED ACTUAL Questions
and CORRECT Answers
What are some s/s of hypothyroidism? non pitting edema
slowed metabolism
cold intolerance
weight gain + decrease in appetite
dry and brittle hair
dry skin
V/S: low RR, HR, and BP
What micronutrient is essential for thyroid hormone iodine
production?
What is it called when hypothyroidism become life - Myxedema coma; occurs as a result of untreated, or poorly managed
threatening? s/s? nursing interventions? hypothyroidism, may occur with acute illness, injury, surgery, chemo, change in
thyroid replacement, or use of sedatives
- s/s: respiratory failure (hypoxia and carbon dioxide retention), low BP,
hypothermia, bradycardia, dysrhythmia, hyponatremia, hypoglycemia, coma,
facial edema, goiter, cold extremities, peripheral edema, constipation
- Nursing interventions: admin O2, replace fluids and electrolytes, admin thyroid
replacement IV, ECG monitoring, keep patient warm, IV hydrocortisone is also
often given to prevent adverse effect of adrenal crisis
What is cretinism? What causes it? Tx? condition of congenital hypothyroidism in children that results in impaired
cognitive function, stunted growth, and poor work performance and behavior
the thyroid gland is either congenitally absent or imperfectly developed (because
of iodine deficiency)
thyroid replacement therapy
What is Hashimoto's thyroiditis? Dx? - def: autoimmune destruction of thyroid gland
- Dx: blood test for antithyroid antibodies
What is the difference in thyroid hormones between - Primary: TSH is high, T3 and T4 are low
primary and secondary/tertiary hypothyroidism - Secondary/tertiary: TSH is normal or low, T3 and T4 are low
What are the thyroid replacement medications and what - Levothyroxine (first line of treatment for hypothyroidism in patients),
are their indications? Liothyronine, Liotrix
- All of these meds should be taken first thing in the morning on an empty
stomach, 30 minutes before breakfast
What is hyperthyroidism? S/S? - increased T3 and T4 hormones which increases the metabolic rate
- S/S: tachycardia, HTN, heat intolerance, weight loss even with increased caloric
consumption, insomnia and fatigue, hair loss, oligomenorrhea or amenorrhea,
anxiety/nervousness, thyroid bruit, increased GI motility
, What autoimmune disease is a type of hyperthyroidism? Graves disease; body makes antibodies against either TSH or against certain cells
S/S? in the thyroid
s/s: causes hyperthyroidism s/s + exophthalmos, goiter, and GI issues
What is it called when hyperthyroidism becomes life - Thyroid storm (Thyrotoxicosis); severely high thyroid hormone levels cause
threatening? S/S? nursing interventions? dangerously overactive metabolism
- S/S: tachycardia, fever, HTN, abd pain, tremors, altered LOC/agitation
- Nursing interventions: airway management, antithyroid meds, radioactive iodine,
beta-blockers for tachycardia, large doses of glucocorticoids, cooling blankets,
monitor for respiratory complications (altered LOC), cardiac dysrhythmias, and
seizures
What is the difference in blood thyroid levels between - Primary: TSH is low while T3 and T4 are high
primary hyperthyroidism and secondary/tertiary - Secondary/tertiary: TSH is high while T3 and T4 are high
hyperthyroidism?
What medications are used to treat hyperthyroidism? Thioamides
MOA? - Propylthiouracil: diverts iodine pathways used to make T4 and blocks conversion
of T4 into T3
- Methimazole: blocks iodine combining with proteins needed to make T4, also
blocks T4 from being converted to T3
- Lithium: concentrates in the thyroid gland to block T4 synthesis
- Radioactive iodine (i 131): decreased blood flow/vascularity of thyroid gland
How do we treat hyperthyroidism if medications do not - Tx: Thyroidectomy
work? pt teaching? nursing considerations? - Ed: Patient will need to take levothyroxine for the rest of their life
- Considerations: monitor calcium levels because damage to the parathyroid
glands can cause hypocalcemia (s/s include muscle spasms, cramps, or aches,
laryngospasm, tingling in lips, mouth, hands, or feet, possible seizures)
What is Addison's disease? hypo-corticosteroid/ adrenal insufficiency
most common in women between 30-50
S/S of addison's disease? hyperpigmentation
weight/water loss
hyponatremia (+ salt craving)
hyperkalemia
hypoglycemia
hypotension
bradycardia or arrhythmia
fatigue and weakness
emotional lability
nausea
abd pain/ gastroenteritis
and CORRECT Answers
What are some s/s of hypothyroidism? non pitting edema
slowed metabolism
cold intolerance
weight gain + decrease in appetite
dry and brittle hair
dry skin
V/S: low RR, HR, and BP
What micronutrient is essential for thyroid hormone iodine
production?
What is it called when hypothyroidism become life - Myxedema coma; occurs as a result of untreated, or poorly managed
threatening? s/s? nursing interventions? hypothyroidism, may occur with acute illness, injury, surgery, chemo, change in
thyroid replacement, or use of sedatives
- s/s: respiratory failure (hypoxia and carbon dioxide retention), low BP,
hypothermia, bradycardia, dysrhythmia, hyponatremia, hypoglycemia, coma,
facial edema, goiter, cold extremities, peripheral edema, constipation
- Nursing interventions: admin O2, replace fluids and electrolytes, admin thyroid
replacement IV, ECG monitoring, keep patient warm, IV hydrocortisone is also
often given to prevent adverse effect of adrenal crisis
What is cretinism? What causes it? Tx? condition of congenital hypothyroidism in children that results in impaired
cognitive function, stunted growth, and poor work performance and behavior
the thyroid gland is either congenitally absent or imperfectly developed (because
of iodine deficiency)
thyroid replacement therapy
What is Hashimoto's thyroiditis? Dx? - def: autoimmune destruction of thyroid gland
- Dx: blood test for antithyroid antibodies
What is the difference in thyroid hormones between - Primary: TSH is high, T3 and T4 are low
primary and secondary/tertiary hypothyroidism - Secondary/tertiary: TSH is normal or low, T3 and T4 are low
What are the thyroid replacement medications and what - Levothyroxine (first line of treatment for hypothyroidism in patients),
are their indications? Liothyronine, Liotrix
- All of these meds should be taken first thing in the morning on an empty
stomach, 30 minutes before breakfast
What is hyperthyroidism? S/S? - increased T3 and T4 hormones which increases the metabolic rate
- S/S: tachycardia, HTN, heat intolerance, weight loss even with increased caloric
consumption, insomnia and fatigue, hair loss, oligomenorrhea or amenorrhea,
anxiety/nervousness, thyroid bruit, increased GI motility
, What autoimmune disease is a type of hyperthyroidism? Graves disease; body makes antibodies against either TSH or against certain cells
S/S? in the thyroid
s/s: causes hyperthyroidism s/s + exophthalmos, goiter, and GI issues
What is it called when hyperthyroidism becomes life - Thyroid storm (Thyrotoxicosis); severely high thyroid hormone levels cause
threatening? S/S? nursing interventions? dangerously overactive metabolism
- S/S: tachycardia, fever, HTN, abd pain, tremors, altered LOC/agitation
- Nursing interventions: airway management, antithyroid meds, radioactive iodine,
beta-blockers for tachycardia, large doses of glucocorticoids, cooling blankets,
monitor for respiratory complications (altered LOC), cardiac dysrhythmias, and
seizures
What is the difference in blood thyroid levels between - Primary: TSH is low while T3 and T4 are high
primary hyperthyroidism and secondary/tertiary - Secondary/tertiary: TSH is high while T3 and T4 are high
hyperthyroidism?
What medications are used to treat hyperthyroidism? Thioamides
MOA? - Propylthiouracil: diverts iodine pathways used to make T4 and blocks conversion
of T4 into T3
- Methimazole: blocks iodine combining with proteins needed to make T4, also
blocks T4 from being converted to T3
- Lithium: concentrates in the thyroid gland to block T4 synthesis
- Radioactive iodine (i 131): decreased blood flow/vascularity of thyroid gland
How do we treat hyperthyroidism if medications do not - Tx: Thyroidectomy
work? pt teaching? nursing considerations? - Ed: Patient will need to take levothyroxine for the rest of their life
- Considerations: monitor calcium levels because damage to the parathyroid
glands can cause hypocalcemia (s/s include muscle spasms, cramps, or aches,
laryngospasm, tingling in lips, mouth, hands, or feet, possible seizures)
What is Addison's disease? hypo-corticosteroid/ adrenal insufficiency
most common in women between 30-50
S/S of addison's disease? hyperpigmentation
weight/water loss
hyponatremia (+ salt craving)
hyperkalemia
hypoglycemia
hypotension
bradycardia or arrhythmia
fatigue and weakness
emotional lability
nausea
abd pain/ gastroenteritis
