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NUR 426 Exam 2 Questions And Correct Answers
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NUR 426 Exam 2 Questions And Correct AnswersThyroid hormone
Needs for metabolic, growth, fetal maturation, cerebral activity, dentition and skeletal
maturation, consumption of oxygen.
Primary hypothyroidism: insult to the gland itself.
Secondary due to either a reduction of TSH from the _____ or reduced TRH from the
_______, interfering with the negative feedback loop.
Graves disease
Common cause of hyperthyroidism caused by autoimmune defect where antibodies
stimulate TSH receptors and cause increase TH release.
nodular thyroid goiter
Occurs more older adults and people low in iodine.
thyroid storm
a relatively rare, life-threatening condition caused by exaggerated hyperthyroidism
subclinical hyperthyroidism
Secondary to excess thyroid hormone therapy.
Hashimoto's thyroiditis
Common cause of primary hypothyroidism where inflammation of the thyroid glands
leads to decreased TH.
*other primary causes include myxedema, radiation, thyroidectomy.
decreased metabolism increases risk of opioid overdose
,Secondary hypothyroidism
decreased TSH from another gland in the H-P axis, congenital.
myxedema coma
extreme hypothyroidism, rare with a high mortality rate
increases, decreases
Hyperthyroidism _______ metabolism of drugs, and hypothyroidism _______ drug
metabolism.
assessment criteria for hypothyroidism
- decreased reflexes, lethargy, slowed speech, blunted emotions, apathy, poor focus
- decreased HR, BP, CO
- catecholamine sensitivity
- anemia, HF
- decreased appetite, constipation
- pale, dry, thick, rough skin and hard, thick nails
- puffy eyes
- hair loss
75-195 mg/dl, 4.6-11.2 mcg/dl
normal ranges for T3 ____ and T4____.
.4-2.0 mu/ml
normal range for TSH
,assessment criteria for hyperthyroidism
- increased reflexes, nervousness, anxiety, insomnia, tremors, restlessness
- increased HR, palpitations, HTN, increased pulse pressure
- sensitive to catecholamines
- dysrhythmias
- HF
- increased appetite, diarrhea
- flushed, warm, thin skin soft thin nails
- sweating
levothyroixine
Thyroid drug
Action:
synthetic T4 that increases metabolism.
AE:
- loss of hair, sweating
- tachycardia, dysrhythmias, HTN, palpitations
Anxiety, insomnia, HA
Dysphagia, esophageal atresia, weight loss, diarrhea
Angina, HF, MI
Hyperthyroidism
, Fracture, decreased bone density
Implications:
Brand specific doses
Start in small doses and gradually titrates up as needed (except in emergency Tx of
myxedema coma).
May take 1-3 weeks to work
Periodic thyroid tests
Interacts with many drugs
Avoid high caffeine
Report to provider for CP, palpitations, insomnia, HR over 100
- give once in the morning ( 6 AM ) on an empty stomach because food alters absorption.
Black box: not for treatment of obesity.
CI:
- hypersensitivity
- thyrotoxicosis
- acute MI related to hypothyroidism
- caution with addisons, lactation, CAD, angina
propylthiouracil
Anti-thyroid drug
Class: thioamides
Action: inhibits production of TH.
Implications:
- drug metabolism is > when beginning therapy (front load dose and then titrate down).
- 1-2 weeks for effects
- monitor T-4
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