Graves Disease and Toxic Multinodular Goiter
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Questions and Answers

What is the extreme state of hyperthyroidism referred to as?

  • Graves disease
  • Hypocalcemia
  • Thyroid storm/crisis (correct)
  • Toxic multinodular goiter

What symptoms should healthcare providers monitor for in a patient experiencing thyroid storm?

  • Hypothermia and bradycardia
  • Restlessness, palpitations, and chest pain (correct)
  • Decreased heart rate and hypotension
  • Fatigue and weight gain

What is a complication associated with thyroid storm/crisis?

  • Nerve Damage
  • Hypothyroidism
  • Hypocalcemia
  • Airway Obstruction (correct)

What is the condition characterized by an inadequate amount of circulating thyroid hormones?

<p>Hypothyroidism (D)</p> Signup and view all the answers

How should healthcare providers treat thyroid storm in terms of fluids and electrolytes?

<p>Replace fluids, glucose, and electrolytes (B)</p> Signup and view all the answers

Which of the following is a risk factor for Graves disease and toxic multinodular goiter?

<p>Family history (B)</p> Signup and view all the answers

What is a common clinical manifestation of Graves disease?

<p>Heat intolerance (A)</p> Signup and view all the answers

Which laboratory test result is typically seen in Graves disease?

<p>Normal Thyroid-stimulating immunoglobulins (A)</p> Signup and view all the answers

What is a common clinical manifestation of toxic multinodular goiter?

<p>Hair loss (C)</p> Signup and view all the answers

Which diagnostic test is used to evaluate the effects of excessive thyroid hormone on the heart?

<p>Electrocardiogram (A)</p> Signup and view all the answers

What does a thyroid scan clarify about the thyroid gland?

<p>Size and function (C)</p> Signup and view all the answers

Which age group is more affected by thyroid function decline according to the text?

<p>Adults between 30-60 years old (A)</p> Signup and view all the answers

What is a common clinical manifestation of hypothyroidism mentioned in the text?

<p>Fluid retention, edema (D)</p> Signup and view all the answers

Which laboratory findings are typically observed in clients with hypothyroidism?

<p>Increased TSH; decreased blood cholesterol (C)</p> Signup and view all the answers

Which risk factor for thyroid function decline is mentioned in the text?

<p>Use of certain medications like lithium and rifampin (A)</p> Signup and view all the answers

What diagnostic procedure involves a low uptake of radioactive preparation in clients with hypothyroidism?

<p>Thyroid scan (D)</p> Signup and view all the answers

What should nurses monitor for in clients with hypothyroidism according to the text?

<p>Cardiovascular changes like low blood pressure and bradycardia (A)</p> Signup and view all the answers

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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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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