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Galen - NUR 257 - Chronic - Chp 20

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Galen - NUR 257 - Chronic - Chp 20

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Galen - NUR 257 - Chronic - Chp 20
Study online at https://quizlet.com/_a28qf5

1. TSH 0.5-5 (High = hypothyroid, low = hyperthyroid)

2. T3 70-220 (low = hypo, high = hyper)

3. T4 5-12 (low = hypo, high = hyper)

4. Thyroid Disease may mimic "normal" aging
(Geriatric Consid- nonspecific, atypical, absent s/s
erations) Often Dx'd when screened for Depression, anxiety, functional/cognitive changes,
cardiac disease
QSEN - amiodarone - monitor for hypothyroidism
Rx centers on pharmacology and Sx or chemical ablation (hyperthyroidism)
tests anytime there may be a concern (even when s/s vague)
those Dx'd with a-fib, anxiety, depression, dementia at risk for thyroid disturbance
little can be done to prevent
iodine and mercury in diet
educate seriousness of disease and following med regimen
acute symptoms and treatment can be life-threatening
labs: TSH, T3, T4

5. Levothyroxine take in am
(RN empty stomach > 30 min before meal
Considerations) full glass of water (so no dissolve in esophagus)
cannot be taken within 4hrs of mineral (fortified calcium foods, antacids, iron
supps)
always dosed in mcgs so watch for mgs
same brand should be used
increasing dose = life-threatening
no rapid replacement b/c toxicity
increases myocardial O2 demand (so a-fib, angina)

6. Hypothyroidism heart palpitations
(S/S) slowed thinking


, Galen - NUR 257 - Chronic - Chp 20
Study online at https://quizlet.com/_a28qf5

gait disturbances

Less common:
fatigue
weakness
depression
dry skin

Significantly less common:
weight gain
cold intolerance
muscle cramps

7. Hyperthyroidism less common than hypo
(Geriatric sudden onset
Considerations) women 2-10 X more likely than men
Common cause: Grave's Disease, iodine substances, amiodarone, too much
levothyroxine
Labs: TSH, T3, T4
May be misdiagnosed as depression, dementia
Untreated can lead to bone loss

8. Hyperthyroidism unexplained a-fib
(S/S) heart failure
constipation
anorexia
muscle weakness
tachycardia
tremors
weight loss
apathetic thyrotoxicosis (rare in young, slowed movement and depressed affect)

9.

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