Term
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Definition
| deficiency of thyroid hormone (TH) |
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Term
| Hypothyroidism results in: |
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Definition
| slow body metabolism, decreased heat production, and decreased oxygen consumption by tissues. |
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Term
Primary Hypothyroidism
(Most common form known as: Hashimotos Disease) |
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Definition
| TH levels low, & TSH (thyroid stimulating hormone) is elevated. |
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Term
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Definition
Insufficient stimulation of normal thyroid gland.
TSH decreased and TSH & TH levels low in serum |
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Term
Tertiary Hypothyroidism
(Central Hypothyroidism) |
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Definition
May be due to tumor or other obstruction in hypothalamus region.
TSH and TH low in serum.
Hypothalamus cannot produce TRH (thyroid releasing hormone) & does not stimulate pituitary to secrete TSH. |
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Term
| Subclinical Hypothyroidism |
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Definition
Increased TSH level but normal/low-normal T4 level.
Manifestations resemble mild hypothyroidism w/ subtle cardiac defects. |
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Term
| Manifestations of Hypothyroidism |
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Definition
| slowing of basal metabolic rate, achlorhydria (decreased secretion of hydrocholric acid in stomach), decreaded GI tract motility, bradycardia, slowed neurologic functioning, decreased heat production, decreased basal body temp. |
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Term
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Definition
Most common form. Develops w/ undiagnosed/undertreated hypothyroidism, that experience stress (trauma, infection, drug use, respiratory/heart failure).
Cold, constipation, lethargy, dry skin, depression, forgetfulness. |
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Term
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Definition
Triggered by noncompliance/stress.
Characterized by: drastic decrease in metabolic rate, hypoventilation leading to respiratory acidosis, hypothermia, HTN.
Complicating conditions: hyponatremia, hypercalcemia secondary to adrenal insufficiency, hypoglycemia, and water intoxication |
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Term
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Definition
| Maintain patent airway, give oxygen, replace fluids IV, pt. kept warm, monitor V/S; vasopressors to maintain tissue perfusion; and Levothyrozine Sodium (Synthroid) given with IV Glucose and Corticosteroids. |
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Term
| Hypothyroidism Medical Management |
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Definition
| Pt take TH for life, Synthroid principal form of replacement therapy; children/older adults get smaller doses; Pts that respond to TH therapy receive maintenance doses of T4 daily for life. |
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Term
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Definition
| Excessive secretion of TH |
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Term
| Information on Hyperthyroidism |
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Definition
| Highly preventable endocrine disorder. Affects mostly women, usually b/t 20-40 years. Due to overfunctioning of entire gland or (less common)single/multiple functioning adenomas of thyroid cancer. |
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Term
| 3 Hallmarks of Graves Disease (Toxic Diffuse Goiter) <-- most common form |
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Definition
1) hyperthyroidism
2) thyroid gland enlargement (goiter)
3) exophthalmos (abnormal protrusion of eyes) |
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Term
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Definition
| Autoimmune disorder mediated by immunoglobulin G (igG)antibody that binds to & activates TSH receptors on surface of thyroid cells. |
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Term
| Maintenance of Graves Disease |
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Definition
| Monitor TH levels, removal of thyroid tumors, administration of anti-thyroid meds |
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Term
| Graves Disease Characterized by: |
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Definition
| loss of normal regulatory controls of TH secretion; metabolism increases greatly leading to negative nitrogen balance, lipid depletion, and state of nutritional deficiency; and weight loss. |
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Term
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Definition
| ravenous appetite, weight loss, diaphoresis, tachycardia; warm, smooth, moist skin; hair thin and soft; W/ goiter the thyroid gland may grow 3-4X in size |
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Term
| Diagnosis of Graves Disease |
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Definition
| confirmed on pt physical appearance (enlarged neck, exopthlamos, agitated expression), agitation, restlessness, weight loss, serum TH increased (sometimes euthyroid), serum cholesterol usually depressed. |
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Term
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Definition
3rd major manifestation of Graves Disease. Protruding eyes & fixed stare.
Manifestations: gritty eye sensation in eye, photophobia, lacrimation, inflammatory changes, dyslogia (difficulty in expressing ideas or speaking) |
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Term
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Definition
| diuretics (may alleviate periorbital edema), Glucocorticoids (Prednisone)((reduce inflammation of periorbital tissues)), Methylcellulose eye drops (reduce eye irritation), Radiation therapy (to retro-orbital tissues for severe cases), surgical decompression. |
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Term
| Comfort Measures for Exopthalmos |
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Definition
| Wear dark glasses, avoid getting dust/dirt in eyes, wear sleeping mask/non-allergic tape to bed, elevate HOB, restrict salt intake to decrease edema. |
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Term
| Thyroid Storm (Thyrotoxicosis) |
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Definition
acute episode of thyroid overactivity.
Characterized by: high fever (>106), severe tachycardia (up to 200 bpm), delirium, dehydration, extreme irritability, systolic HTN.
No lab tests can differentiate b/w hyperthyroidism and thyroid storm!
A-Fib almost always accompanies thyrotoxicosis. Heart failure found among older pts. w/ long standing thyrotoxicosis. |
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Term
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Definition
Anti-thyroid meds recommended for pts. younger than 18 & pregnant women.
Main Meds: Iodide, Propylthiouracil, & Methimazole (Tapazole), adrenergic blocking agents may be used. |
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Term
Hyperthyroid Med.:
Propylthiouracil |
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Definition
| Most common anti-thyroid med used. Most serious toxic effect is agranulocytosis. (Failure of bone marrow to make enough WBCs) |
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Term
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Definition
| Med of choice is potassium iodide; Logul's Solution (is also used) tends to inactivate anti-thyroid preps in bowel. |
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Term
| Hyperthyroid Med not for pregnant or below 18 |
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Definition
Radioactive Iodide. Mainly for middle age and older patients.
Manifestations: subside w/in 6-12 weeks after radioactive iodine (I) |
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Term
| Management of Thyroid Storm (Thyrotoxicosis) |
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Definition
| hypothermia blankets, suppress hormone release, inhibit hormone synthesis, block conversion of T4 to T3, inhibit effects of TH on body tissues, treat precipitating cause. |
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Term
| Thyroidectomy (removal of thyroid gland) |
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Definition
Total performed to remove thyroid cancer. 6/6th of gland removed.
Subtotal to correct hyperthyroidism & extreme simple goiter. 5/6th of the gland removed. |
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Term
| Hypocalcemia after Thyroidectomy |
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Definition
S/S: muscle twitching, hyperirritability of nervous system.
Develops after thyroidectomy if parathyroid glands removed.
May develop 1-7 days after surgery.
Monitor for (+) Chvostek's & Trousseau's Sign
Notify MD if pt. numbness; tingling around mouth, fingertips, toes; muscle spasm, or twitching. Calcium Gluconate should be available. |
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Term
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Definition
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