NUR 311
What two hormones does the thyroid produce? -Correct Answers ✔-
Triiodothyronine T3
Thyroxine T4
Which thyroid hormone is converted in the periphery? -Correct Answers ✔-T4 is
converted to T3
Which thyroid hormone is more potent? -Correct Answers ✔-T3
Describe the steps of thyroid hormone regulation. (TRH, TSH, T3, T4, negative
feedback loop) -Correct Answers ✔-TRH from hypothalamus ------> TSH from
anterior pituitary------>T3 & T4 from thyroid---->inhibit TSH from anterior
pituitary
Describe the relationship of TSH levels to T3 and T4 levels. -Correct Answers ✔-
Low T3 or T4 increases TSH, high T3 or T4 lowers TSH
Describe common clinical signs and symptoms of hypothyroidism? -Correct
Answers ✔-Goiter; puffy, expressionless face; cold/dry skin; brittle hair; hair loss
from scalp & outer half of eyebrows; fatigue; irritability; depression; lack of
concentration; cold intolerance; constipation; heavy menses; increased cholesterol
Persons over 50 years of age may need what change in the initial dose of
levothyroxine? -Correct Answers ✔-Lowered
Discuss the effects on the fetus of maternal hypothyroidism in pregnancy. -Correct
Answers ✔-Decreased IQ and neuropsychological function of the child.
Discuss the effects of congenital hypothyroidism in infants. -Correct Answers ✔-
Mental retardation, large tongue, pot belly, dwarfish stature, derangement of
growth - nerves, muscles, bone, teeth
How long until levothyroxine reaches a plateau? -Correct Answers ✔-One month
NUR 311
,NUR 311
Levothyroxine should be given with or without food? -Correct Answers ✔-Without
food
Discuss the expected change in TSH when a patient is responding to levothyroxine.
-Correct Answers ✔-TSH decreases to normal levels
Describe the signs and symptoms of thyrotoxicosis. -Correct Answers ✔-
Tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, sweating, weight loss, increased appetite.
Which drugs can cause decreased absorption of levothyroxine? How many hours
after the administration of levothyroxine may these drugs be given? -Correct
Answers ✔-H2-recptor blockers, proton pump inhibitors, bile-acid sequestrants
such as colestyramine (Questran) and colestipol (Colestid); sucralfate (Carafate);
calcium, iron, magnesium, aluminum.
4 hours.
Why would a nurse administer levothyroxine with caution to a patient on warfarin?
-Correct Answers ✔-Levothyroxine increases the degradation of Vitamin K-
dependent clotting factors and may increase the chance of bleeding. May need to
decrease dose of warfarin.
What is the interaction between catecholamines and levothyroxine? -Correct
Answers ✔-Levothyroxine increases the body's response to epinephrine,
norepinephrine, and dopamine.
Why might liothyronine (Cytomel) be given instead of levothyroxine
(Levothyroid)? -Correct Answers ✔-Rapid onset of action in myxedema coma.
Discuss the nursing care of a patient with hypothyroidism. -Correct Answers ✔-
Life-long replacement; take on an empty stomach; monitor for hypothyroidism &
hyperthyroidism; hold levothyroxine if pulse >100/min & call primary care
NUR 311
, NUR 311
provider; monitor TSH, T3 & T4; minimize adverse drug interactions; monitor
warfarin levels.
What are the symptoms of thyrotoxic crisis (thyroid storm)? What usually triggers
it? -Correct Answers ✔-Restlessness, agitation, tremor, severe tachycardia,
hypotension, heart failure, hyperthermia, profound weakness, unconsciousness,
coma.
Severe illness or major surgery.
What mimics TSH in patients with Grave's Disease? -Correct Answers ✔-Thyroid-
stimulating immunoglobulins (TSI)
What are some signs and symptoms of Grave's Disease? -Correct Answers ✔-
Rapid, strong heartbeat; rapid thoughts & speech; trouble concentrating; tremor;
insomnia; weakened muscles; increased body temperature; warm, moist skin;
increased appetite with weight loss; diarrhea; exophthalmos.
What TSH level is expected with hyperthyroidism? -Correct Answers ✔-
Decreased TSH
Give two ways propylthiouracil (PTU) works in hyperthyroidism? -Correct
Answers ✔-Inhibits thyroid hormone synthesis by inhibiting peroxidase.
Suppresses conversion of T4 to T3 in the periphery.
Name a blood disorder caused by thionamides? -Correct Answers ✔-
Agranulocytosis - may see sore throat or fever.
What may happen to thyroid hormone production after the use of a thionamide? -
Correct Answers ✔-Hypothyroidism
How does Tapazole (methimazole) work differently from PTU? -Correct Answers
✔-Inhibits thyroid hormone synthesis, but does not block T4 or T3 in the
periphery.
NUR 311
What two hormones does the thyroid produce? -Correct Answers ✔-
Triiodothyronine T3
Thyroxine T4
Which thyroid hormone is converted in the periphery? -Correct Answers ✔-T4 is
converted to T3
Which thyroid hormone is more potent? -Correct Answers ✔-T3
Describe the steps of thyroid hormone regulation. (TRH, TSH, T3, T4, negative
feedback loop) -Correct Answers ✔-TRH from hypothalamus ------> TSH from
anterior pituitary------>T3 & T4 from thyroid---->inhibit TSH from anterior
pituitary
Describe the relationship of TSH levels to T3 and T4 levels. -Correct Answers ✔-
Low T3 or T4 increases TSH, high T3 or T4 lowers TSH
Describe common clinical signs and symptoms of hypothyroidism? -Correct
Answers ✔-Goiter; puffy, expressionless face; cold/dry skin; brittle hair; hair loss
from scalp & outer half of eyebrows; fatigue; irritability; depression; lack of
concentration; cold intolerance; constipation; heavy menses; increased cholesterol
Persons over 50 years of age may need what change in the initial dose of
levothyroxine? -Correct Answers ✔-Lowered
Discuss the effects on the fetus of maternal hypothyroidism in pregnancy. -Correct
Answers ✔-Decreased IQ and neuropsychological function of the child.
Discuss the effects of congenital hypothyroidism in infants. -Correct Answers ✔-
Mental retardation, large tongue, pot belly, dwarfish stature, derangement of
growth - nerves, muscles, bone, teeth
How long until levothyroxine reaches a plateau? -Correct Answers ✔-One month
NUR 311
,NUR 311
Levothyroxine should be given with or without food? -Correct Answers ✔-Without
food
Discuss the expected change in TSH when a patient is responding to levothyroxine.
-Correct Answers ✔-TSH decreases to normal levels
Describe the signs and symptoms of thyrotoxicosis. -Correct Answers ✔-
Tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, sweating, weight loss, increased appetite.
Which drugs can cause decreased absorption of levothyroxine? How many hours
after the administration of levothyroxine may these drugs be given? -Correct
Answers ✔-H2-recptor blockers, proton pump inhibitors, bile-acid sequestrants
such as colestyramine (Questran) and colestipol (Colestid); sucralfate (Carafate);
calcium, iron, magnesium, aluminum.
4 hours.
Why would a nurse administer levothyroxine with caution to a patient on warfarin?
-Correct Answers ✔-Levothyroxine increases the degradation of Vitamin K-
dependent clotting factors and may increase the chance of bleeding. May need to
decrease dose of warfarin.
What is the interaction between catecholamines and levothyroxine? -Correct
Answers ✔-Levothyroxine increases the body's response to epinephrine,
norepinephrine, and dopamine.
Why might liothyronine (Cytomel) be given instead of levothyroxine
(Levothyroid)? -Correct Answers ✔-Rapid onset of action in myxedema coma.
Discuss the nursing care of a patient with hypothyroidism. -Correct Answers ✔-
Life-long replacement; take on an empty stomach; monitor for hypothyroidism &
hyperthyroidism; hold levothyroxine if pulse >100/min & call primary care
NUR 311
, NUR 311
provider; monitor TSH, T3 & T4; minimize adverse drug interactions; monitor
warfarin levels.
What are the symptoms of thyrotoxic crisis (thyroid storm)? What usually triggers
it? -Correct Answers ✔-Restlessness, agitation, tremor, severe tachycardia,
hypotension, heart failure, hyperthermia, profound weakness, unconsciousness,
coma.
Severe illness or major surgery.
What mimics TSH in patients with Grave's Disease? -Correct Answers ✔-Thyroid-
stimulating immunoglobulins (TSI)
What are some signs and symptoms of Grave's Disease? -Correct Answers ✔-
Rapid, strong heartbeat; rapid thoughts & speech; trouble concentrating; tremor;
insomnia; weakened muscles; increased body temperature; warm, moist skin;
increased appetite with weight loss; diarrhea; exophthalmos.
What TSH level is expected with hyperthyroidism? -Correct Answers ✔-
Decreased TSH
Give two ways propylthiouracil (PTU) works in hyperthyroidism? -Correct
Answers ✔-Inhibits thyroid hormone synthesis by inhibiting peroxidase.
Suppresses conversion of T4 to T3 in the periphery.
Name a blood disorder caused by thionamides? -Correct Answers ✔-
Agranulocytosis - may see sore throat or fever.
What may happen to thyroid hormone production after the use of a thionamide? -
Correct Answers ✔-Hypothyroidism
How does Tapazole (methimazole) work differently from PTU? -Correct Answers
✔-Inhibits thyroid hormone synthesis, but does not block T4 or T3 in the
periphery.
NUR 311
