17 Questions
What is the extreme state of hyperthyroidism referred to as?
Thyroid storm/crisis
What symptoms should healthcare providers monitor for in a patient experiencing thyroid storm?
Restlessness, palpitations, and chest pain
What is a complication associated with thyroid storm/crisis?
Airway Obstruction
What is the condition characterized by an inadequate amount of circulating thyroid hormones?
Hypothyroidism
How should healthcare providers treat thyroid storm in terms of fluids and electrolytes?
Replace fluids, glucose, and electrolytes
Which of the following is a risk factor for Graves disease and toxic multinodular goiter?
Family history
What is a common clinical manifestation of Graves disease?
Heat intolerance
Which laboratory test result is typically seen in Graves disease?
Normal Thyroid-stimulating immunoglobulins
What is a common clinical manifestation of toxic multinodular goiter?
Hair loss
Which diagnostic test is used to evaluate the effects of excessive thyroid hormone on the heart?
Electrocardiogram
What does a thyroid scan clarify about the thyroid gland?
Size and function
Which age group is more affected by thyroid function decline according to the text?
Adults between 30-60 years old
What is a common clinical manifestation of hypothyroidism mentioned in the text?
Fluid retention, edema
Which laboratory findings are typically observed in clients with hypothyroidism?
Increased TSH; decreased blood cholesterol
Which risk factor for thyroid function decline is mentioned in the text?
Use of certain medications like lithium and rifampin
What diagnostic procedure involves a low uptake of radioactive preparation in clients with hypothyroidism?
Thyroid scan
What should nurses monitor for in clients with hypothyroidism according to the text?
Cardiovascular changes like low blood pressure and bradycardia
Study Notes
Graves Disease and Toxic Multinodular Goiter
- Risk factors: family history, increased iodine intake, smoking, ages 30-50, pregnancy
- Prevention: educate individuals with family history, encourage smoking cessation
Clinical Manifestations
- Increased appetite and weight loss
- Hyper-motile bowels
- Diarrhea
- Heat intolerance
- Insomnia
- Palpitations
- Increased sweating
- Skin/Hair changes
- Goiter
- Proptosis
- Exophthalmos
- Thyroiditis
- Inflammation of the thyroid gland
Laboratory Tests
- Blood TSH level: decreased in Graves disease, elevated in secondary or tertiary hyperthyroidism
- Free T4 index, T4 (total), T3: elevated in the presence of disease
- Thyroid-stimulating immunoglobulins: elevated in Graves disease, normal in other types of hyperthyroidism
- Thyrotropin receptor antibodies: elevation most indicative of Graves disease
Diagnostics
- Ultrasound: used to produce images of the thyroid gland and surrounding tissue
- Electrocardiogram: used to evaluate the effects of excessive thyroid hormone on the heart
- Thyroid scan: nuclear medicine test to clarify size and function of the gland
Hypothyroidism
- Risk factors: females 30-60 years old, use of certain medications, inadequate intake of iodine, radiation therapy to the head and neck
- Clinical manifestations:
- Slow onset
- Goiter
- Fluid retention, edema
- Decreased appetite, weight gain
- Constipation
- Dry skin
- Dyspnea
- Pallor
- Hoarseness
- Pulse typically low
- Sleep apnea
- Diagnostics:
- T3, T4: decreased
- Blood thyroid-stimulating hormone (TSH): increased in primary hypothyroidism, decreased or within the expected reference range in secondary hypothyroidism
- Blood cholesterol: increased
- Antithyroid antibodies: present in some cases
- Diagnostic procedures:
- Thyroid scan: low uptake of radioactive preparation
- ECG: sinus bradycardia, dysrhythmias
Nursing Care
- Monitor for cardiovascular changes, chest pain, and peripheral edema
- Check weight regularly
- Orient client periodically and provide safety measures if mental status is compromised
Thyroid Storm/Crisis
- Extreme state of hyperthyroidism
- Monitor for rapid increase in metabolic rate, fever, increased HR, hyperthermia, tachycardia, systolic hypertension, GI symptoms, restlessness, palpitations, chest pain
- Requires rapid treatment: cooling, replacing fluids, glucose, and electrolytes, relieving respiratory distress, stabilizing cardiovascular function, reducing thyroid hormones
Learn about the risk factors, clinical manifestations, and prevention strategies for Graves disease and toxic multinodular goiter. Explore symptoms like increased appetite, weight loss, heat intolerance, and more.
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