NR 565 Final Study Guide Chamberlain University-Illinois | UPDATED
Questions with 100% Verified Answers
Question:
WEEK 5
Answer:
...
Question:
Thyroid o Diagnosis & Evaluation What labs are used to
diagnose?
Answer:
-TSH - used primarily for screening and diagnosing
hypothyroid and for monitoring replacement therapy in
hypothyroid patients
-T4 - Used to monitor thyroid hormone replacement therapy
and to screen for thyroid dysfunction
-T3 - Useful in the diagnosis of hyperthyroidism; can also be
used to monitor hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Question:
Thyroid o Diagnosis & Evaluation Timeframe for re-check of
labs after starting levothyroxine?
Answer:
Recheck TSH 6-8 weeks after initiating therapy and after any
dosage change; Check TSH at least once a year after serum
TSH is stabilized
Question:
Thyroid o Diagnosis & Evaluation Signs and symptoms of
hypothyroidism?
, Answer:
Hypothyroidism: Depend on severity. o Mild: subtle and may
go unrecognized o Moderate to severe:
-Face is pale, puffy, and expressionless.
-Skin cold and dry.
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
-Patient may complain of lethargy, fatigue, and
-Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if reduced levels of T3 and
T4 Mentation may be impaired.
Question:
Thyroid o Diagnosis & Evaluation Signs and symptoms of
hyperthyroidism?
Answer:
o Elevated Heart rate and strong, and dysrhythmias and
angina may develop o The CNS is stimulated, resulting is
nervousness, insomnia, rapid thought flow, and rapid speech,
hyperreflexia, tremors o Skeletal muscles may weaken and
atrophy o Metabolic rate is raised, resulting in health and skin
that is warm and moist o Feeling Hot + Heat intolerance o
Appetit is increased but fails to match metabolic rate resulting
in weight loss o All of these signs are referred to as
thyrotoxicosis o Also usually present with exophthalmos -
bulging of the eyes
Question:
Thyroid o Treatment Treatment of thyroid storm?
Answer:
Characterized by profound hyperthermia (105 degrees F or
higher), severe tachycardia, restlessness, agitation, and
tremor. Unconsciousness, coma, hypotension, and heart
,failure may ensure. These symptoms are produced by
excessive levels of thyroid hormone Thyroid crisis can be life
threatening and requires immediate treatment. o High doses of
potassium iodide or strong iodine solution are given to
suppress thyroid hormone release. o Methimazole is given to
suppress thyroid hormone synthesis o A beta blocker is given
to reduce heart rate o Additional measures include sedation,
cooling, and giving glucocorticoids and IVF
Question:
Thyroid o Treatment Result of not treating hypothyroidism
during pregnancy?
Answer:
Can result in permanent neuropsychological deficits in the
child - decrease child's IQ The effect of hypothyroidism is
limited largely to the first trimester, a time during which the
fetus is unable to produce thyroid hormone of its own Some
authorities currently recommend routine screening for
hypothyroidism as soon as pregnancy is confirmed Women
already taking thyroid hormone replacement will need to
increase dose by 50% max between weeks 4-8 of gestation
and the levels will level out by week 16
Question:
Thyroid o Treatment Medication to treat symptoms of
hyperthyroidism (notice this is treating symptoms and not the
hyperthyroidism itself)
Answer:
Methimazole - first line drug of choice (not given to women
who are pregnant or breastfeeding) o Methimazole blocks
synthesis of thyroid hormone.
1) Prevents the oxidation of iodine, therefore inhibiting
incorporation of iodine into tyrosine.
, 2) prevents iodinated tyrosine from coupling Propylthiouracil
- preferred treatment for thyroid storm Beta blockers - help
with tachycardia experienced with hyperthyroidism
Question:
Thyroid o Treatment Drug/Food/Supplement interactions with
levothyroxine
Answer:
Absorption of levothyroxine is reduced by food - it should be
taken on an empty stomach in the morning, at least 30-60
minutes before breakfast Drugs that reduce absorption
include: H2 receptor blockers, PPIs, Carafate, Questran,
Colestid, Maalox/Mylanta, Tums, iron, Mag salts, Xenical
Drugs that accelerate levothyroxine: Phenytoin,
Carbamazepine, rifampin, Sertraline, and phenobarbital
Patients taking the following drugs may need to increase their
dose of levothyroxine: Warfarin and catecholamines
Levothyroxine can also increase requirements for insulin and
digoxin
Question:
Diabetes o How to confirm a diagnosis prior to beginning
treatment
Answer:
Fasting plasma glucose >/= 125mg/dl OR Random plasma
glucose >/= 200mg/dl plus symptoms of diabetes (polyuria,
polydipsia, unexplained weight loss) OR Oral glucose
tolerance test (OGTT): 2-hour plasma glucose >/= 200mg/dl
OR HgbA1C pf 6.5% or greater - (a test that provides an
estimate of glycemic control over the previous 2-3 months) is
now considered a standard test as well
Questions with 100% Verified Answers
Question:
WEEK 5
Answer:
...
Question:
Thyroid o Diagnosis & Evaluation What labs are used to
diagnose?
Answer:
-TSH - used primarily for screening and diagnosing
hypothyroid and for monitoring replacement therapy in
hypothyroid patients
-T4 - Used to monitor thyroid hormone replacement therapy
and to screen for thyroid dysfunction
-T3 - Useful in the diagnosis of hyperthyroidism; can also be
used to monitor hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Question:
Thyroid o Diagnosis & Evaluation Timeframe for re-check of
labs after starting levothyroxine?
Answer:
Recheck TSH 6-8 weeks after initiating therapy and after any
dosage change; Check TSH at least once a year after serum
TSH is stabilized
Question:
Thyroid o Diagnosis & Evaluation Signs and symptoms of
hypothyroidism?
, Answer:
Hypothyroidism: Depend on severity. o Mild: subtle and may
go unrecognized o Moderate to severe:
-Face is pale, puffy, and expressionless.
-Skin cold and dry.
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
-Patient may complain of lethargy, fatigue, and
-Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if reduced levels of T3 and
T4 Mentation may be impaired.
Question:
Thyroid o Diagnosis & Evaluation Signs and symptoms of
hyperthyroidism?
Answer:
o Elevated Heart rate and strong, and dysrhythmias and
angina may develop o The CNS is stimulated, resulting is
nervousness, insomnia, rapid thought flow, and rapid speech,
hyperreflexia, tremors o Skeletal muscles may weaken and
atrophy o Metabolic rate is raised, resulting in health and skin
that is warm and moist o Feeling Hot + Heat intolerance o
Appetit is increased but fails to match metabolic rate resulting
in weight loss o All of these signs are referred to as
thyrotoxicosis o Also usually present with exophthalmos -
bulging of the eyes
Question:
Thyroid o Treatment Treatment of thyroid storm?
Answer:
Characterized by profound hyperthermia (105 degrees F or
higher), severe tachycardia, restlessness, agitation, and
tremor. Unconsciousness, coma, hypotension, and heart
,failure may ensure. These symptoms are produced by
excessive levels of thyroid hormone Thyroid crisis can be life
threatening and requires immediate treatment. o High doses of
potassium iodide or strong iodine solution are given to
suppress thyroid hormone release. o Methimazole is given to
suppress thyroid hormone synthesis o A beta blocker is given
to reduce heart rate o Additional measures include sedation,
cooling, and giving glucocorticoids and IVF
Question:
Thyroid o Treatment Result of not treating hypothyroidism
during pregnancy?
Answer:
Can result in permanent neuropsychological deficits in the
child - decrease child's IQ The effect of hypothyroidism is
limited largely to the first trimester, a time during which the
fetus is unable to produce thyroid hormone of its own Some
authorities currently recommend routine screening for
hypothyroidism as soon as pregnancy is confirmed Women
already taking thyroid hormone replacement will need to
increase dose by 50% max between weeks 4-8 of gestation
and the levels will level out by week 16
Question:
Thyroid o Treatment Medication to treat symptoms of
hyperthyroidism (notice this is treating symptoms and not the
hyperthyroidism itself)
Answer:
Methimazole - first line drug of choice (not given to women
who are pregnant or breastfeeding) o Methimazole blocks
synthesis of thyroid hormone.
1) Prevents the oxidation of iodine, therefore inhibiting
incorporation of iodine into tyrosine.
, 2) prevents iodinated tyrosine from coupling Propylthiouracil
- preferred treatment for thyroid storm Beta blockers - help
with tachycardia experienced with hyperthyroidism
Question:
Thyroid o Treatment Drug/Food/Supplement interactions with
levothyroxine
Answer:
Absorption of levothyroxine is reduced by food - it should be
taken on an empty stomach in the morning, at least 30-60
minutes before breakfast Drugs that reduce absorption
include: H2 receptor blockers, PPIs, Carafate, Questran,
Colestid, Maalox/Mylanta, Tums, iron, Mag salts, Xenical
Drugs that accelerate levothyroxine: Phenytoin,
Carbamazepine, rifampin, Sertraline, and phenobarbital
Patients taking the following drugs may need to increase their
dose of levothyroxine: Warfarin and catecholamines
Levothyroxine can also increase requirements for insulin and
digoxin
Question:
Diabetes o How to confirm a diagnosis prior to beginning
treatment
Answer:
Fasting plasma glucose >/= 125mg/dl OR Random plasma
glucose >/= 200mg/dl plus symptoms of diabetes (polyuria,
polydipsia, unexplained weight loss) OR Oral glucose
tolerance test (OGTT): 2-hour plasma glucose >/= 200mg/dl
OR HgbA1C pf 6.5% or greater - (a test that provides an
estimate of glycemic control over the previous 2-3 months) is
now considered a standard test as well
