Hyperthyroidism and Hypothyroidism Overview

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Questions and Answers

What is a common physical characteristic of Cushing's Syndrome?

Muscle hypertrophy

Weight loss

Truncal obesity (correct)

Hyperthyroidism

What should be monitored for a patient who is receiving IV Ca gluconate for calcium levels below 6.9?

Vital signs only

Patient's blood glucose levels (FSBS)

Patient must be on a monitor (correct)

Electrolyte levels only

What is often a psychological impact of physical changes in Cushing's Syndrome?

Increased anxiety and depression (correct)

Total emotional stability

Improved social interactions

Enhanced self-esteem

Which dietary modification is typically recommended for patients with Cushing's Syndrome?

Low sodium, high potassium Signup and view all the answers

What is a potential effect of prolonged corticosteroid use?

Decreased immunity Signup and view all the answers

What is a clinical manifestation associated with hyperglycemia in Cushing's Syndrome?

Muscle wasting Signup and view all the answers

Why is monitoring for edema important in patients with Cushing's Syndrome?

It can signal complications from treatments Signup and view all the answers

What is a non-physical change that healthcare providers should monitor in a patient with Cushing's Syndrome?

Mental wellbeing Signup and view all the answers

What is one of the main causes of hyperparathyroidism?

Benign neoplasm of the parathyroid gland Signup and view all the answers

What symptom should be monitored in a patient with hyperparathyroidism?

Tetany Signup and view all the answers

What is a common treatment for hyperthyroidism?

Antithyroid drugs Signup and view all the answers

Which electrolyte imbalance is indicative of hyperparathyroidism?

Increased serum calcium Signup and view all the answers

Which condition is a potential result of inadequate secretion of parathyroid hormone (PTH)?

Hypoparathyroidism Signup and view all the answers

Which of the following is a symptom associated with hypothyroidism?

Weight gain Signup and view all the answers

What underlying condition can lead to hyperthyroidism?

Grave's disease Signup and view all the answers

What is a common sign of hypoparathyroidism?

Muscle cramps and spasms Signup and view all the answers

What might prolonged QT interval on an EKG indicate in a patient with hypoparathyroidism?

Low calcium levels Signup and view all the answers

What dietary adjustment is recommended for a patient with hyperthyroidism?

High calorie diet with frequent snacks Signup and view all the answers

Which symptom is indicative of hypothyroidism?

Cold intolerance Signup and view all the answers

What condition can result from the removal of the parathyroid gland?

Hypoparathyroidism Signup and view all the answers

Which medication is commonly prescribed for hypothyroidism?

Thyroid hormone replacements Signup and view all the answers

Which of the following is NOT a symptom associated with hypoparathyroidism?

Increased energy levels Signup and view all the answers

What is one of the recommended treatments for managing hypoparathyroidism?

Administering calcium and vitamin D Signup and view all the answers

Which of these is a serious risk associated with untreated hypothyroidism?

Myxedema coma Signup and view all the answers

In patients with hyperparathyroidism, what should be monitored for potential neurological complications?

Seizures Signup and view all the answers

What lifestyle modification is important for managing hyperthyroidism?

Increase fluid intake Signup and view all the answers

What can result from excessive production of thyroid hormone in hyperthyroidism?

Increased cardiac output Signup and view all the answers

Which complication should be monitored in patients receiving treatment for hyperthyroidism?

Thyroid storm Signup and view all the answers

What is a common cause of adrenal insufficiency in Addison's disease?

Autoimmune reactions Signup and view all the answers

Which of the following electrolyte imbalances is typically associated with Addison's disease?

Hyponatremia and hyperkalemia Signup and view all the answers

What symptom is commonly observed in patients with Addison's disease due to hormonal imbalance?

Weight loss Signup and view all the answers

What dietary recommendation is typically given to patients with Addison's disease?

High sodium, low potassium diet Signup and view all the answers

Which physical change can indicate hyperpigmentation in Addison's disease?

Bronze skin Signup and view all the answers

What should be monitored in patients with Addison's disease to watch for complications?

Blood glucose for hypoglycemia Signup and view all the answers

Which of the following is a critical reaction to educate patients and their families about regarding Addison's disease?

Adrenal crisis Signup and view all the answers

What form of therapy is essential for managing Addison's disease?

Hormone replacement therapy Signup and view all the answers

What is a notable effect of hypercortisolism associated with Cushing's Syndrome?

Increased sodium and water retention Signup and view all the answers

Which condition is likely to develop due to prolonged corticosteroid use?

Cushing's Syndrome Signup and view all the answers

What is essential when administering IV calcium gluconate for calcium levels below 6.9?

Ensure the patient is monitored Signup and view all the answers

What is a common dietary recommendation for individuals with Cushing's Syndrome?

Low sodium, high potassium Signup and view all the answers

What physical characteristic is frequently associated with Cushing's Syndrome?

Truncal obesity Signup and view all the answers

How does hyperglycemia manifest in patients with Cushing's Syndrome?

Increased thirst and urination Signup and view all the answers

What must healthcare providers monitor for patients with Cushing's Syndrome to prevent complications?

Skin integrity and healing Signup and view all the answers

Which factor may contribute to fatigue in patients with Cushing's Syndrome?

Muscle wasting and weakness Signup and view all the answers

What is a common cause of hypoparathyroidism?

Damage to or removal of the parathyroid gland Signup and view all the answers

What is a typical symptom of hyperparathyroidism?

Frequent urination Signup and view all the answers

Which electrolyte imbalance is associated with hypoparathyroidism?

Decreased serum calcium Signup and view all the answers

What should be monitored in a patient with hypoparathyroidism for potential complications?

Electrocardiogram for prolonged QT interval Signup and view all the answers

What is a primary treatment strategy for managing osteoporosis in patients with hyperparathyroidism?

Administer bisphosphonates Signup and view all the answers

What is a potential neurological symptom to monitor for in patients with hypoparathyroidism?

Facial dysesthesia Signup and view all the answers

What condition may result from hypersecretion of parathyroid hormone (PTH)?

Hypercalcemia Signup and view all the answers

What lifestyle change is recommended to help manage symptoms of hypoparathyroidism?

Engage in regular weight-bearing exercise Signup and view all the answers

Which symptom might indicate chronic complications in a patient with hyperparathyroidism?

Abdominal pain with constipation Signup and view all the answers

What monitoring practice is essential for patients with hyperparathyroidism?

Monitoring serum calcium and phosphate levels Signup and view all the answers

Which symptom is most directly associated with hyperthyroidism?

Increased appetite Signup and view all the answers

What is a common treatment option for hypothyroidism?

Levothyroxine Signup and view all the answers

Which of the following manifestations is typical for hyperthyroidism?

Goiter Signup and view all the answers

What dietary consideration is important for a patient with hypothyroidism?

Low-calorie, high-protein and fiber diet Signup and view all the answers

Which condition is a potential cause of hyperthyroidism?

Grave's disease Signup and view all the answers

What is a significant risk to monitor for patients receiving treatment for hyperthyroidism?

Thyroid storm Signup and view all the answers

What is a manifestation of hypothyroidism?

Difficulty concentrating Signup and view all the answers

Which treatment method is NOT used for managing hyperthyroidism?

Thyroid hormone replacement Signup and view all the answers

Which symptom indicates hypothyroidism?

Hair loss Signup and view all the answers

What complication is unlikely to occur in patients with untreated hypothyroidism?

Increased metabolism Signup and view all the answers

What is a primary cause of adrenal insufficiency in Addison's disease?

Autoimmune response Signup and view all the answers

Which of the following electrolytes is typically decreased in Addison's disease?

Sodium Signup and view all the answers

What is a hallmark physical sign of Addison's disease?

Bronze skin pigmentation Signup and view all the answers

What symptom may indicate hypoglycemia in a patient with Addison's disease?

Tachycardia Signup and view all the answers

What psychological symptoms may be observed in patients with Addison's disease?

Apathy Signup and view all the answers

Which dietary recommendation is essential for patients with Addison's disease?

High sodium intake Signup and view all the answers

What is a critical aspect of patient education for those with Addison's disease?

Emergency kit for hormone replacement therapy Signup and view all the answers

What condition may result from inadequate production of adrenal hormones in Addison's disease?

Addisonian crisis Signup and view all the answers

Study Notes

Hyperthyroidism

Excess production and circulation of thyroid hormone (TH)
Causes: overfunctioning of the thyroid (Graves’ Disease), thyroid cancer, thyroid hormone replacement
Manifestations: Goiter, hypertension, increased cardiac output, hypertrophy, increased appetite, weight loss, hair loss, thin and brittle nails, mood swings, insomnia
Treatments:
- High calorie diet with frequent snacks (increased carbohydrates and protein)
- Increased fluid intake (oral and IV)
- Antithyroid drugs
- Beta Blockers
- Radioactive Iodine Therapy
Nursing Considerations: Monitor for signs and symptoms of thyroid storm

Hypothyroidism

Deficiency of TH
Causes: autoimmune (Hashimoto's), decreased thyroid function, anterior pituitary problems, removal of thyroid gland
Manifestations: Decreased cardiac output, shortness of breath, exercise intolerance, constipation, weight gain, cold intolerance, fatigue, weakness, depression
Treatments:
- Low calorie, high protein and fiber diet
- Levothyroxine (Synthroid) - monitor for angina and dysrhythmias
Nursing Considerations: Teach about lifelong HRT, required labs, monitor for signs and symptoms of myxedema coma and thyroid storm

Hyperparathyroidism

Excess of Parathyroid Hormone (PTH)
Causes: benign neoplasm of the parathyroid gland(s), renal failure
Manifestations: Nausea/vomiting, constipation, osteoporosis, pathologic fractures, depression, psychosis, increased urine calcium, kidney stones, hypertension, cardiac dysrhythmias, increased serum calcium and decreased serum phosphorus
Treatments:
- Surgery
Nursing Considerations: Watch for tetany, monitor neurologic status, teach pt about risk factors for fractures, biphosphonates, exercise to build bone, stool softeners, increased PO fluids

Hypoparathyroidism

Inadequate secretion of PTH or failure of target cells to respond to PTH
Causes: damage to or removal of thyroid or parathyroid gland, radiation to the neck area
Manifestations: Abdominal and muscle cramps, numbness, tingling, cramps, fatigue, weakness, depression, seizures, dysrhythmias, hyperactive DTRs, decreased serum calcium and increased serum phosphorus
Treatments:
- Oral calcium and Vitamin D supplements
- IV calcium gluconate for calcium less than 6.9 - Pt must be on a monitor!
Nursing Considerations: Watch for tetany (Chvostek's and Trousseau's signs), monitor neurologic status and seizures, monitor EKG for prolonged QT and ST interval, monitor respiratory status

Hypercortisolism (Cushing’s Syndrome)

Excess of glucocorticoids
Causes: prolonged corticosteroid use, ACTH-secreting pituitary tumor, adrenal neoplasm
Manifestations: Truncal obesity, round face, buffalo hump, muscle wasting, hyperglycemia, decreased wound healing, fatigue, weakness, increased sodium and water retention, decreased immunity
Treatments:
- Low sodium, high potassium, and low carbohydrate diet
- Surgery
Nursing Considerations: Provide emotional support, monitor FSBS for hyperglycemia, protect skin and assess wounds for delayed healing, monitor edema

Adrenocortical Insufficiency (Addison's Disease)

Decreased glucocorticoids, mineralocorticoids, and androgens
Causes: Usually autoimmune; hypofunction of the adrenal glands, lack of pituitary ACTH secretion
Manifestations: Weight loss, depression, apathy, bronze skin hyperpigmentation, fatigue, weakness, hypotension, decreased sodium, increased potassium, decreased blood glucose
Treatments:
- High sodium, low potassium, and high carbohydrate diet
- Monitor EKG for peaked T waves
- Teach pt to carry emergency kit containing HRT
Nursing Considerations: Monitor FSBS for hypoglycemia, monitor for dehydration and encourage fluids, teach signs and symptoms of Addisonian Crisis to pt and family

Hyperthyroidism

Excess production and circulation of Thyroid Hormone (TH)
Causes: overfunctioning of thyroid (Grave's Disease), thyroid cancer, thyroid hormone replacement
Manifestations: Goiter, HTN, increased cardiac output, hypertrophy, increased appetite, weight loss despite increased appetite, hair loss, thin & brittle nails, mood swings, insomnia
Treatments: High calorie diet with frequent snacks (increased carbs & protein), fluids (oral, IV) , antithyroid drugs, beta blockers, radioactive iodine therapy
Nursing Considerations: Monitor for signs and symptoms of thyroid storm

Hypothyroidism

Deficiency of TH
Causes: autoimmune (Hashimoto's), decreased thyroid function, anterior pituitary problems, removal of thyroid gland
Manifestations: Decreased cardiac out, SOB, exercise intolerance, constipation, weight gain despite decreased appetite, cold intolerance, fatigue,
Treatments: Low calorie, high protein & fiber diet, Levothyroxine (Synthroid)
Nursing Considerations: Monitor for angina, dysrhythmias, monitor for signs and symptoms of myxedema coma, teach about lifelong HRT, required labs, monitor for signs and symptoms of thyroid storm

Hyperparathyroidism

Excess of Parathyroid Hormone (PTH)
Causes: Benign neoplasm of the parathyroid gland(s), renal failure
Manifestations: Nausea/vomiting, constipation, osteoporosis, pathologic fractures, depression, psychosis, increased urine calcium, kidney stones, HTN, cardiac dysrhythmias, increased serum Ca & decreased serum Phos
Treatments: Surgery
Nursing Considerations: Watch for tetany, monitor neuro status, teach pt about risk factors for fractures, bisphosphonates, exercise to build bone, stool softeners, increased PO fluids

Hypoparathyroidism

Inadequate secretion of PTH or failure of target cells to respond to PTH
Causes: Damage to or removal of thyroid or parathyroid gland, radiation to the neck area
Manifestations: Abdominal & muscle cramps, numbness, tingling, cramps, fatigue, weakness, depression, seizures, dysrhythmias, hyperactive DTRs, decreased serum Ca & increased serum Phos
Treatments: Oral calcium & Vitamin D supplements, IV calcium gluconate for Ca levels less than 6.9
Nursing Considerations: Watch for tetany (Chvostek's & Trousseau's signs), monitor neuro status, monitor EKG for prolonged QT, ST interval, monitor respiratory status, patient must be on a monitor

Hypercortisolism (Cushing's Syndrome)

Excess of Glucocorticoids
Causes: Prolonged corticosteroid use, ACTH-secreting pituitary tumor, adrenal neoplasm
Manifestations: Truncal obesity, round face, buffalo hump, muscle wasting, hyperglycemia, decreased wound healing, fatigue, weakness, increased Na & H20 retention, edema, decreased immunity
Treatments: ? Surgery
Nursing Considerations: Provide emotional support due to physical changes, monitor FSBS for hyperglycemia, protect skin, assess wounds for delayed healing, teach low Na, high K, low carb diet

Adrenocortical Insufficiency (Addison's Disease)

Decreased Glucocorticoids, mineralocorticoids, & androgens
Causes: Usually autoimmune, hypofunction of the adrenal glands, lack of pituitary ACTH secretion -Manifestations: Weight loss, depression, apathy, bronze skin hyperpigmentation, fatigue, weakness, hypotension due to hypovolemia, decreased Na, increased K, decreased blood glucose
Treatments: ? Surgery
Nursing Considerations: Monitor FSBS for hypoglycemia, monitor for dehydration, encourage fluids, teach high Na, low K, high carb diet, monitor EKG for peaked T wave, teach patient to carry emergency kit containing HRT, teach signs and symptoms of Addisonian crisis to patient and family

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Description

This quiz covers the key aspects of hyperthyroidism and hypothyroidism, including their causes, manifestations, treatments, and nursing considerations. Test your understanding of the differences between excessive and deficient thyroid hormone production. Ideal for nursing students and healthcare professionals.