Potpourri
REPORTABLE CHANGES
WHAT is TEMP INCREASE OF 1 DEGREE, PALPITATIONS AND CHEST PAIN?
5 clinical manifestations seen with Hyperthyroidism.
What is
· Exophthalmos
· Nervousness- Irritability- restlessness- hand tremors
· Palpitations- A-Fib or Sinus Tachycardia
· Tachycardia
SBP is elevated
· Heat intolerance
· Sweating
· Skin is flushed, warm, moist
· Pruritis
· Increased appetite
· Weight loss
· Muscle fatigue
&
· Increased peristalsis?
When hyperthyroid should drugs be taken.
When hypothyroid should drugs be taken.
What is (hyperthyroid) same time each day?
What is (hypothyroid) same time each morning?
The following assessment findings would indicate that the client is experiencing the therapeutic effects from levothyroxine (Synthroid). Select all that apply.
What is :
a. decreased reports of fatigue
c. pulse rate between 60-100 beats/min
e. decreased blood cholesterol levels?
A nurse is caring for an older adult client in a long-term care facility who has hypothyroidism and is beginning levothyroxine (Synthroid). Which of the following dosage schedules should the nurse expect for this client? A. The client will start at a high dose, and the dose will be tapered down as needed. B. The client will remain on the initial dosage during the course of treatment. C. The clients dosage will be adjusted daily based on blood levels. D. The client will start on a low dose, which will be gradually increased
What is the client will start on a low dose, which will be gradually increased?
Collaborative Goals
WHAT IS TO REDUCE HORMONES SECRETIONS AND REDUCE EFFECTS ON CARDIAC FUNCTION?
5 Gerontological considerations in a client with Hyperthyroidism.
What is
· Less common then hypothyroid
· Anorexia/ weight loss unexplained
· Isolated episodes of A-Fib
· New or worsening heart failure (complain of difficulty climbing stairs)
· Mental deterioration
· Treatment is with radioactive iodine over antithyroid medications due to the side effects and they are less effective in the elderly
· Beta-blockers may be necessary to treat symptoms of thyroid storm (thyrotoxicosis)
Levothyroxine (Synthroid) increases the effects of this anticoagulant drug.
What are Warfarin (Coumadin)?
This therapy works to decrease hyperthyroid symptoms by destroying thyroid tissue.
Use of this therapy can lead to hypothyroidism.
What is Radioactive Iodine Therapy?
The reason Propylthiouracil (PTU) contain a Black Box warning.
What is hepatic toxicity?
The following symptoms can indicate the following condition:
FEVER, TACHYCARDIA AND SYSTOLIC HYPERTENSION *STILL MAY DIE W/TREATMENT
WHAT IS THYROID STORM?
The only thyroid level that is decreased in hyperthyroidism.
What is TSH?
High doses of thyroid medication (Levothyroxine (Synthroid) can lead to thyrotoxicosis. Signs and symptoms of Thyrotoxicosis include _______
What is headache, fever, agitation, confusion, sweating, weight loss, vomiting, diarrhea, tachycardia & angina?
A severe case of thyrotoxicosis is called thyroid storm, or thyroid crisis.
This condition is rare and requires immediate medical attention, as it can be life-threatening.
RELIEF OF DIAPHORESIS, TACHYCARDIA AND PALPITATIONS
WHAT ARE BETA ADRENERGIC BLOCKERS?
A nurse is caring for a client who is taking propylthiouracil (PTU). For which of the following adverse effects of this medication should the nurse monitor? a) insomnia b) weight loss c) heat intolerance d) bradycardia
What is bradycardia?
Clinical manifestations of hyperthyroidism.
What is sweating, fatigue, finger clubbing, skinny,
palpitations, tachycardia, & increased systolic BP?
True or False:
Levothyroxine (Synthroid) can be used for weight loss.
What is false?
It’s not recommended, safe, or effective for weight loss. Taking high doses of levothyroxine (Synthroid) can cause serious or fatal effects especially if used with other medications for weight loss.
Priority interventions for a client with Hyperthyroidism?
What is
Encourage high calorie diet (4000-5000 calories/Day) increase carbs, protein, low fiber foods,
· Foods and fluids selected to replace fluid loss through diarrhea
· Nutritional balance avoids taking stimulants (NO caffeine, soda, coffee tea, ETOH)
· Monitor patient's complications of for thyrotoxicosis (AKA thyrotoxic crisis or thyroid storm). Requires monitoring nursing interventions in ICU.
· Ensure rest, cool environment, exercise large muscle groups, supportive/trusting relationship for coping with irritable, restless patient.
· Protect eyes
&
· Treatment—reducing thyroid hormone levels— Propylthiouracil (PTU) or Methimazole?
Avoid administering these drugs when a patient is on propylthyiouracil (PTU)
What are anticoagulants and iodine-containing agents?
Possible complications following a thyroidectomy.
What is bleeding at the incision site, airway obstruction, stridor, hypocalcemia & tetany?
This condition causes the skin to look waxy & swollen.
What is MYEXEDMA Coma?
These 2 medications work to block T3 & T4 production.
What is PTU & TAPAZOLE?
Treatment options to control Graves’ disease hyperthyroidism include:
What is Antithyroid drugs (generally methimazole (Tapazole), although propylthiouracil (PTU) may be used in rare instances such as the first trimester of pregnancy), radioactive iodine and surgery.
What is Antithyroid drugs (Methimazole (Tapazole), Propylthiouracil (PTU)?
What is radioactive iodine and surgery?
A client asks a nurse why she is taking propranolol (Inderal) along with her therapy for hyperthyroidism. Which of the following replies by the nurse is appropriate? A. “Propranolol helps increase blood flow to your thyroid gland.” B. “Propranolol is used to prevent excess glucose in your blood.” C. “Propranolol will decrease your tremors and fast heart beat.” D. “Propranolol promotes conversion of T4 to T3 in your body.”
What is “Propranolol will decrease your tremors and fast heart beat.”?