Nursing Management of Thyroid Disorders hard

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Questions and Answers

What complication can arise from untreated hyperthyroidism related to calcium levels?

  • Hypercalcemic crisis (correct)
  • Hypocalcemic shock
  • Hypoparathyroid crisis
  • Thyroid storm

Which of the following is NOT a common symptom of hypocalcemia seen in hypoparathyroidism?

  • Muscle hypertonia
  • Tremors and spasms
  • Decreased muscle tone (correct)
  • Numbness and tingling

When managing a patient with hyperthyroidism, which dietary factor is crucial for maintaining health?

  • Increased fiber for bowel regularity
  • Balanced calcium-phosphorus intake (correct)
  • High protein intake
  • Low carbohydrate diet

What is a common risk factor for developing hyperthyroidism in women aged 20-40?

<p>Emotional stress (B)</p> Signup and view all the answers

What is the primary nursing intervention for a patient experiencing hypercalcemic crisis?

<p>Administer isotonic saline and maintain urine output (B)</p> Signup and view all the answers

Which of the following is an important aspect of patient education for those with hypothyroidism?

<p>Consistency in medication timing is essential, ideally first thing in the morning (B)</p> Signup and view all the answers

What hormonal imbalance results from hypoparathyroidism?

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

What neurological symptom may indicate severe hypocalcemia?

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

Which condition is a common cause of hyperthyroidism associated with excessive thyroid hormone production?

<p>Graves' disease (D)</p> Signup and view all the answers

Flashcards

Hypothyroidism Medication Effects

Analgesics, sedatives, and anesthetics can have longer-lasting effects on patients with hypothyroidism, requiring close monitoring for side effects by nurses.

Hyperthyroidism Cause

Overproduction of thyroid hormone, either naturally or from outside sources (e.g., medication). Common causes include Graves' disease and toxic goiter.

Hyperthyroidism Prevalence

Women are affected eight times more often than men, usually between 20 and 40 years old, often linked to stress, infections, and shocks.

Hyperthyroidism Calcium Balance

Nurses must monitor patients for calcium and phosphorus imbalances and any complications that might arise.

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Hypercalcemic Crisis Definition

A life-threatening condition with high calcium levels (over 13 mg/dL) causing neurological, cardiovascular, and kidney problems.

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Hypercalcemic Crisis Treatment

Immediate treatment involves rehydration (to maintain urine flow), calcitonin to reduce calcium levels and bone breakdown, and if needed, diuretics for edema.

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Hypoparathyroidism Definition

Low production of parathyroid hormone (PTH), leading to low calcium and high phosphorus in the blood.

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Hypoparathyroidism Cause

Causes include surgery (thyroid or parathyroid), immune system issues, and vitamin D deficiency.

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Hypocalcemia Symptoms

Muscle issues, tingling, spasms, difficulty swallowing, breathing issues, and potential heart/brain problems.

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Importance of Follow-up Testing (Thyroid)

Regular check-ups are crucial to monitor the ongoing effectiveness of treatments and ensure healthy levels of calcium and thyroid hormones.

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Study Notes

Hypothyroidism Nursing Management

  • Medication side effects warrant close monitoring in hypothyroid patients. Analgesics, sedatives, and anesthetics can have prolonged effects.
  • Educate patients on medication administration (e.g., taking first thing in the morning with water), adhering to schedules, recognizing when to seek medical attention, and the importance of diet for weight management and bowel health. Emphasize the need for follow-up testing.

Hyperthyroidism Overview

  • Excessive thyroid hormone production (endogenous or exogenous) is the cause. Common causes include Graves' disease, toxic multinodular goiter, and toxic adenoma, along with thyroiditis and excessive hormone intake.
  • Hyperthyroidism predominantly affects women aged 20-40, and occurs 8 times more frequently in women.
  • Emotional stress, infection, or shock are possible triggers for hyperthyroidism.

Hyperthyroidism Nursing Management

  • Maintaining calcium-phosphorus balance and avoiding related issues are crucial for hyperthyroid patients.
  • Frequent follow-up appointments are essential to ensure serum calcium levels return to normal.

Hypercalcemic Crisis (Complication of Hyperthyroidism)

  • Hypercalcemic crisis occurs when serum calcium levels exceed 13 mg/dL. It's a life-threatening condition with significant neurological, cardiovascular, and kidney symptoms.
  • Immediate treatment is critical. This includes rapid rehydration with isotonic saline to maintain urine output (100-150 mL/hour), calcitonin administration to reduce calcium levels and bone breakdown, and loop diuretics if edema develops.

Hypoparathyroidism

  • Hypoparathyroidism is defined by low parathyroid hormone (PTH) production.
  • The result is hypocalcemia and hyperphosphatemia.
  • Causes can include thyroidectomy, parathyroidectomy, autoimmune responses, and vitamin D deficiency.

Hypoparathyroidism Clinical Manifestations

  • Hypocalcemia symptoms include muscle hypertonia, tremors, spasms, numbness/tingling in extremities, hand/foot stiffness, bronchospasm, laryngeal spasm, carpopedal spasm, dysphagia, photophobia, cardiac dysrhythmias, and seizures. Anxiety, irritability, depression, and delirium may also manifest. ECG changes and hypotension are possible side effects.

Hypoparathyroidism Nursing Management

  • Post-operative monitoring for hypocalcemia, tetany, seizures, and respiratory problems is essential after thyroid/parathyroid surgeries or neck dissection procedures.
  • Ensure ready access to calcium gluconate for emergency IV administration.
  • Continuous cardiac monitoring and careful assessment are critical in patients with cardiac conditions due to the effects of calcium and digitalis on systolic contraction.

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