Nur611 Final Exam – Questions With Proper Answers
1. Thyroid primary dysfunction: Located at the thyroid gland
2. Thyroid secondary dysfunction: Located at the pituitary gland
3. Thyroid tertiary dysfunction: Located at the hypothalamus
4. TSH: thyroid stimulating hormone; stimulates uptake & storage of iodine by thyroid
cells & release of T3 + T4
5. T3: thyroid hormone; short half-life; more potent; associated w/ graves disease
6. T4: thyroid hormone; longer half-life
7. TRH: thyrotropin releasing hormone; stimulates thyrotropin cells in anterior pituitary
to release TSH
8. Calcitonin: secreted by thyroid gland in response to high plasma calcium levels
9. Thyroid: diagnostic tests: TSH, T3, T4, inverted TSH in response to T3/T4 levels,
ultrasound, CT, MRI, thyroid scan(radioactive iodine reuptake)
10. Thyroidectomy: tx for thyroid cancer; modified or radial neck dissection;
radioactive iodine to minimize tumors
11. Thyroidectomy: PreOp: minimize stress/anxiety; no caffeine/stimulants; low-
iodine diet; avoid salt, seafood, dairy, eggs, soy, chocolate
12. Thyroidectomy: PostOp: risk for infection, bleeding, airway, pain management,
potential for hypoglycemia, HOB raised > 30, keep neck in neutral position
13. Hypothyroid: lack of T3/T4; increase in TSH
14. Hashimoto's: primary hypothyroidism; autoimmune attacks the thyroid causing
decrease in T4 & increase in TSH as compensation; 95% of hypothyroidism
15. Hypothyroidism: Medications: Levothyroxine (Synthroid)
16. Levothyroxine: Nursing Considerations: take on empty stomach; monitor TSH
frequently; do not stop taking or change dosage; fiber, calcium, iron, antacid
supplements interfere w/ absorption; monitor for irritability, tachycardia,
palpitations, heat intolerance & rapid weight loss
17. hypothyroid complications: myxedema coma; decompensated hypothyroidism
18. Myxedema coma s/s: decrease in mental status; hypothermia, bradycardia, acute
coronary syndrome, hypoventilation/resp. (risk for respiratory acidosis); failure,
shock, hypoglycemia, death (high mortality)
19. Myxedema coma: cases: sepsis; cold exposure; surgery; burns; trauma; medication
noncompliance
20. Myxedema coma: treatments: maintain airway; administer levothyroxine &
hydrocortisone; dextrose for hypoglycemia; treating symptoms (atropine -
bradycardia; oxygen/pressured therapy - hypoventilation)
1/5
, 21. Hyperthyroid s/s: fine brittle hair; hair loss; bulging eyes; sweating; goiter; enlarged
liver; arrhythmia, N/V/D, increased appetite; unexplained weight loss, loss of libido,
amenorrhea, irritability, hyperactivity; hyperglycemia; intolerance to heat; low
cholesterol
22. Goiter: increase in size of gland from increased demand; can become toxic; caused
from low iodine; over/underproduction of thyroid hormone; may affect airway r/t
tracheal compression; treat the cause
23. thyroid storm/thyrotoxicosis: can be triggered d/t thyroidectomy; induces hyper-
metabolic state; increases nutrition use, O2 consumption, heat
production/hyperthermia, shifts fluid/electrolyte balance
24. thyroid storm/thyrotoxicosis s/s: fever, tachycardia, GI, cardiac symptoms, altered
mental status
25. thyroid storm/thyrotoxicosis: treatment: beta blockers, antihypertensives, cooling
measures, antipyretics, oxygen, glucose
26. Hyperthyroid medications: inhibits conversion of T4 to T3; thionamides (inhibits
synthesis); sodium or potassium iodine solutions (inhibits release); dexamethasone
(steroid - inhibit conversion)
27. Grave's Disease: autoimmune disorder resulting in abnormal antibody stimulation
of the thyroid; most common cause of hyperthyroidism; women 8x more than men
28. Type 1 Diabetes: insulin deficiency; risk from autoimmune/pancreatic disorders
(CF); genetics; autoimmune related
29. Type 2 Diabetes: insulin resistance/impaired secretion; family hx; obesity; race; age
> 45; HTN; HDL > 35; triglycerides > 250; gestational DM; delivery of baby > 9lbs
30. hypoglycemia s/s: pale, cool, sweaty skin, hunger, increased irritability; changes in
LOC; take blood sugar
31. hypoglycemia treatment: fast acting carbs (apple juice); IV dextrose; subQ
glucagon
32. hyperglycemia s/s: polydipsia; polyuria; headache; dry mouth
33. hyperglycemia dx: fasting glucose at/above 126; oral glucose tolerance; random
glucose > 200; HGB 4-6: pre; >7: +; post brandial < 140; urine testing for
ketones/proteins
34. hyperglycemia treatment: insulin
35. Diabetes Mellitus: Long term complications: diabetic foot ulcers; slow wound
healing; neuropathy; retinopathy
36. HHS: d/t insufficient insulin; occurs in Type 2 diabetics; results in osmotic diuresis;
loss of H2O & electrolytes; hypernatremia; increase osmolality (high mortality)
37. HHS s/s: hypoTN; dehydration; BG > 600; variable mental status
38. HHS treatment: rehydration; IV insulin; potassium supplement
1. Thyroid primary dysfunction: Located at the thyroid gland
2. Thyroid secondary dysfunction: Located at the pituitary gland
3. Thyroid tertiary dysfunction: Located at the hypothalamus
4. TSH: thyroid stimulating hormone; stimulates uptake & storage of iodine by thyroid
cells & release of T3 + T4
5. T3: thyroid hormone; short half-life; more potent; associated w/ graves disease
6. T4: thyroid hormone; longer half-life
7. TRH: thyrotropin releasing hormone; stimulates thyrotropin cells in anterior pituitary
to release TSH
8. Calcitonin: secreted by thyroid gland in response to high plasma calcium levels
9. Thyroid: diagnostic tests: TSH, T3, T4, inverted TSH in response to T3/T4 levels,
ultrasound, CT, MRI, thyroid scan(radioactive iodine reuptake)
10. Thyroidectomy: tx for thyroid cancer; modified or radial neck dissection;
radioactive iodine to minimize tumors
11. Thyroidectomy: PreOp: minimize stress/anxiety; no caffeine/stimulants; low-
iodine diet; avoid salt, seafood, dairy, eggs, soy, chocolate
12. Thyroidectomy: PostOp: risk for infection, bleeding, airway, pain management,
potential for hypoglycemia, HOB raised > 30, keep neck in neutral position
13. Hypothyroid: lack of T3/T4; increase in TSH
14. Hashimoto's: primary hypothyroidism; autoimmune attacks the thyroid causing
decrease in T4 & increase in TSH as compensation; 95% of hypothyroidism
15. Hypothyroidism: Medications: Levothyroxine (Synthroid)
16. Levothyroxine: Nursing Considerations: take on empty stomach; monitor TSH
frequently; do not stop taking or change dosage; fiber, calcium, iron, antacid
supplements interfere w/ absorption; monitor for irritability, tachycardia,
palpitations, heat intolerance & rapid weight loss
17. hypothyroid complications: myxedema coma; decompensated hypothyroidism
18. Myxedema coma s/s: decrease in mental status; hypothermia, bradycardia, acute
coronary syndrome, hypoventilation/resp. (risk for respiratory acidosis); failure,
shock, hypoglycemia, death (high mortality)
19. Myxedema coma: cases: sepsis; cold exposure; surgery; burns; trauma; medication
noncompliance
20. Myxedema coma: treatments: maintain airway; administer levothyroxine &
hydrocortisone; dextrose for hypoglycemia; treating symptoms (atropine -
bradycardia; oxygen/pressured therapy - hypoventilation)
1/5
, 21. Hyperthyroid s/s: fine brittle hair; hair loss; bulging eyes; sweating; goiter; enlarged
liver; arrhythmia, N/V/D, increased appetite; unexplained weight loss, loss of libido,
amenorrhea, irritability, hyperactivity; hyperglycemia; intolerance to heat; low
cholesterol
22. Goiter: increase in size of gland from increased demand; can become toxic; caused
from low iodine; over/underproduction of thyroid hormone; may affect airway r/t
tracheal compression; treat the cause
23. thyroid storm/thyrotoxicosis: can be triggered d/t thyroidectomy; induces hyper-
metabolic state; increases nutrition use, O2 consumption, heat
production/hyperthermia, shifts fluid/electrolyte balance
24. thyroid storm/thyrotoxicosis s/s: fever, tachycardia, GI, cardiac symptoms, altered
mental status
25. thyroid storm/thyrotoxicosis: treatment: beta blockers, antihypertensives, cooling
measures, antipyretics, oxygen, glucose
26. Hyperthyroid medications: inhibits conversion of T4 to T3; thionamides (inhibits
synthesis); sodium or potassium iodine solutions (inhibits release); dexamethasone
(steroid - inhibit conversion)
27. Grave's Disease: autoimmune disorder resulting in abnormal antibody stimulation
of the thyroid; most common cause of hyperthyroidism; women 8x more than men
28. Type 1 Diabetes: insulin deficiency; risk from autoimmune/pancreatic disorders
(CF); genetics; autoimmune related
29. Type 2 Diabetes: insulin resistance/impaired secretion; family hx; obesity; race; age
> 45; HTN; HDL > 35; triglycerides > 250; gestational DM; delivery of baby > 9lbs
30. hypoglycemia s/s: pale, cool, sweaty skin, hunger, increased irritability; changes in
LOC; take blood sugar
31. hypoglycemia treatment: fast acting carbs (apple juice); IV dextrose; subQ
glucagon
32. hyperglycemia s/s: polydipsia; polyuria; headache; dry mouth
33. hyperglycemia dx: fasting glucose at/above 126; oral glucose tolerance; random
glucose > 200; HGB 4-6: pre; >7: +; post brandial < 140; urine testing for
ketones/proteins
34. hyperglycemia treatment: insulin
35. Diabetes Mellitus: Long term complications: diabetic foot ulcers; slow wound
healing; neuropathy; retinopathy
36. HHS: d/t insufficient insulin; occurs in Type 2 diabetics; results in osmotic diuresis;
loss of H2O & electrolytes; hypernatremia; increase osmolality (high mortality)
37. HHS s/s: hypoTN; dehydration; BG > 600; variable mental status
38. HHS treatment: rehydration; IV insulin; potassium supplement
