Nurse 623 Exam 2 Guide questions and answers(graded A+)

What is Hypothyroidism -ANSWER- -inadeqaute amount of thyroid hormone being produced or secreted. -Most common in women ages 30-60 "Hashiamotos" -Look at T4 levels: normal 100-125 per day What is a goiter -ANSWER- hypertrophy and hyperplasia of the thyroid gland caused by increasing levels of pituitary TSH Subjective symptoms of Hypothtroidism -ANSWER- " Everythng sluggish" swelling, nausea constipation, menorrhagia, muscle weakness, weight gain, fatigue, lethargy Objective Signs and SYmptoms of hypothyroidism -ANSWER- slowing of mental process/ dul facila expression/ hypoactive bowel sounds/ bradykenesia/ bradycardia/ cardiac enlargement/ pleurel effusion/ decreased fertility Hypothyroidism work up -ANSWER- Baseline screening at age 35.. especially with those pregnant, >60 or autoimmune disease TSH, Free T4 Antithyroid antibodies to check for thyroiditis Diagnostic values: TSH high/ T4 low TSH>10 needs treatment If palpating nodules need US Hypothyroidism treatment -ANSWER- -Synthroid( brand specific and prefered over generic) -Levothyroxine: overtreatment can cause osteoporosis -start at 50-100 mcg/day ( 25mcg for elderly) Increase by 25 mcg/day evry 4-6 weeks, max of 300 until TSH in normal reange Complications of treatment with Hypothyroidism -ANSWER- if untreated myexedema.... Pt education with Hypothyroidism -ANSWER- -Take med in early am to javoid insomnia -do not take at same time as mineral supplements take 2 hours before ir 4 hours after -Thyroid supplements can increase glucose -may have decreased sensitivity to sedatives/ analgesics -low fat diet due to risk of heart disease -high fiber diet to reduce constipation -wear extra clothing -S/s of thyrotoxicity (hyperthyroidism)