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Questions and Answers
What is the extreme state of hyperthyroidism referred to as?
What is the extreme state of hyperthyroidism referred to as?
What symptoms should healthcare providers monitor for in a patient experiencing thyroid storm?
What symptoms should healthcare providers monitor for in a patient experiencing thyroid storm?
What is a complication associated with thyroid storm/crisis?
What is a complication associated with thyroid storm/crisis?
What is the condition characterized by an inadequate amount of circulating thyroid hormones?
What is the condition characterized by an inadequate amount of circulating thyroid hormones?
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How should healthcare providers treat thyroid storm in terms of fluids and electrolytes?
How should healthcare providers treat thyroid storm in terms of fluids and electrolytes?
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Which of the following is a risk factor for Graves disease and toxic multinodular goiter?
Which of the following is a risk factor for Graves disease and toxic multinodular goiter?
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What is a common clinical manifestation of Graves disease?
What is a common clinical manifestation of Graves disease?
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Which laboratory test result is typically seen in Graves disease?
Which laboratory test result is typically seen in Graves disease?
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What is a common clinical manifestation of toxic multinodular goiter?
What is a common clinical manifestation of toxic multinodular goiter?
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Which diagnostic test is used to evaluate the effects of excessive thyroid hormone on the heart?
Which diagnostic test is used to evaluate the effects of excessive thyroid hormone on the heart?
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What does a thyroid scan clarify about the thyroid gland?
What does a thyroid scan clarify about the thyroid gland?
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Which age group is more affected by thyroid function decline according to the text?
Which age group is more affected by thyroid function decline according to the text?
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What is a common clinical manifestation of hypothyroidism mentioned in the text?
What is a common clinical manifestation of hypothyroidism mentioned in the text?
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Which laboratory findings are typically observed in clients with hypothyroidism?
Which laboratory findings are typically observed in clients with hypothyroidism?
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Which risk factor for thyroid function decline is mentioned in the text?
Which risk factor for thyroid function decline is mentioned in the text?
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What diagnostic procedure involves a low uptake of radioactive preparation in clients with hypothyroidism?
What diagnostic procedure involves a low uptake of radioactive preparation in clients with hypothyroidism?
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What should nurses monitor for in clients with hypothyroidism according to the text?
What should nurses monitor for in clients with hypothyroidism according to the text?
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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
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Description
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.
