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