Pharmacology
In SIADH, which medications should be discontinued?
ADH stimulants.
What endocrine disorder is commonly associated with polyuria and polydipsia manifestations?
Diabetes insipidus.
What endocrine disorder typically uses a water deprivation test for diagnostic purposes?
Central Diabetes Insipidus
What should the nurse discuss with the patient regarding the importance of thyroid hormone therapy?
Need for lifelong therapy; take medications in the morning before food; ensure regular follow-up care and monitoring of thyroid hormone levels are fulfilled.
Although airway obstruction is not common in thyroidectomy surgery, what are some requirements needed at the bedside to rectify airway obstruction?
In acute DI, which fluids are given and titrated to replace urine output?
IV hypotonic fluids/d5 in water.
Signs and symptoms of iodine toxicity?
Swelling of buccal mucosa and other mucous membranes, excess salivation, nausea and vomiting, skin reactions.
Before a water deprivation test, what are the four categories that must be measured?
Body weight, urine osmolality, volume, and specific gravity.
After thyroid surgery, what should nurses be assessing that is related to verbal abilities?
Ability to speak aloud, voice quality, tone, and problems with speaking.
What may be the result of a patient suffering from hypoventilation, hyponatremia, hypoglycemia, and lactic acidosis.
Beta blocker of choice in hyperthyroid patients with asthma or heart disease.
Signs of myxedema.
Puffiness, facial and periorbital edema, with mask-like effects.
What are the most reliable thyroid function tests?
TSH and free T4.
True or False: patient's should be cautioned on doubling doses of anti-thyroid medications.
True.
Some patients notice weight loss and are tempted to increase dosing to achieve desired weight.
Because constipation is often a complication associated with hypothyroidsm, how can patients minimize the occurence?
Gradually increase activity and exercise, increase fiber, use stool softeners, ensure they have regular bowel elimination time, AVOID using enemas - these cause vagal stimulation which is hazardous if the patient also struggle with heart disease.
After starting antithyroid medications in hyperthyroidism, when are improvements often seen?
1-2 weeks after the start of drug therapy.
Acropachy.
Clubbing of digits, often seen in patients with advanced thyroid disease.
What is the purpose of serum TSH levels?
They help determine the cause of hypothyroidism.
What should be monitored after administering any IV glucose solutions?
Serum glucose levels, BP, HR, urine output, LOC and specific gravity.
What are commen postoperative complications associated with thyroid surgery?
Hypothyroidism, damage to or inadvertent removal of parathyroid glands [cause hypoparathyroidism and hypocalcemia], hemorrhage, injury to recurrent or superior laryngeal nerve damage.
Mechanism of Action for Demeclocycline:
Blocks the effects of ADH on the renal tubules, resulting in more dilute urine.
What are the systemic effects of hypothyroidism?
Slowing of body processes; depends on severity and the duration of the thyroid deficiency.
How is SIADH typically diagnosed?
Urine and serum osmolality measurements.
After thyroid surgery, what position should patient's be in to prevent tension on the suture line?
semi-Fowler's with head and neck pillows, avoiding neck flexion.
Cause of acute thyrotoxicosis:
Excess amounts of thyroid hormones are released into the circulation; life-threatening but death is rare.