Hypo/Hyperparathyroidism & Hypo/Hyperthyroidism & THYROID STORM – Flashcards

Dehydration Confusion Lethargy Arrhythmias Anorexia N/V Weight loss Constipation Thirst Frequent urination Hypertension Increased serum calcium levels Decreased serum phosphate levels Increased bone resorption Increased calcium and phosphate in urine Decreased neuromuscular irritabillity

Parathyroid tumor Congenital enlargement Neck trauma or irradiation Vitamin D deficiency Chronic renal failure with hypocalcemia Lung, kidney, or GI tract cancers

Mild tingling Numbness Muscle cramps Mental changes (Irritability) Positive Chvostek sign Positive Trousseau sign Tetany Convulsions Cardiac dysrhythmias Spasms of the layrnx

Atrophy or traumatic injury to the parathyroid glands (this can occur as a result of accidental removal or destruction of parathyroid tissue during a thyroidectomy, irradation of the thyroids, neck trauma, or from idiopathic atrophy of the thyroid glands.

Weight loss (early) Nervousness (early) Weakness Insomnia Tremulousness Agitation Tachycardia Palpitations Exertional dsypnea Ankle edema Difficulty concentrating Diarrhea Increased thirst and urination Decreased libido Scanty menstruation Infertillity

Primary (Grave's Disease or Toxic Goiter): Result of an abnormality of function involving the thyroid gland itself, and causes excessive circulation of T3 & T4 hormones Secondary: Usually the result of an abnormality in another gland, such as the pituitary gland, that could produce too much TSH and therefore overstimulate the thyroid gland.

May be treated medically by administering radioactive iodine and antithyroid drugs, mild sedatives, and beta-adrengergic blocking agents to control tremor, temperature elevation, restlessness, and tachycardia. All patients receiving radioactive iodine treatment must be observed for signs of thyroid crisis resulting from radiation-induced thyroiditis

Decrease in appetite Increase in weight (slow metabolic rate) Bagginess under the eyes Swelling of the face Lethargy Sleeping for long periods of time Sluggish mentally and physically Cold intolerance Constipation Abdominal distension Flatulence Impaired memory Depression Husky voice Thinning eyebrows Hair loss Brittle nails Easy bruising Fatigue Numbness and tingling Dry skin Nonpitting edema

Can be caused by inflammation of the thyroid gland, iodine deficiency, genetic defects, decreased TSH secretion, hypothalamus dysfunction, atrophy of the thyroid gland, or by treatment of hyperthyroidism, that results in destroying too many thyroid cells and a resultant deficit of thyroid hormone.

Massage with lotions and creams to prevent cracking of the skin, provisions for extra warmth, making sure the patient receives their thyroid medication every day. Avoid rushing hypothyroid patients or giving them the impression of being annoyed by their sluggishness.

For patients on diuretic therapy; accurate measuring of I's & O's every 2-4 hours, daily weight, monitoring of serum electrolytes, ongoing assessment for electrolyte imbalance, and appropriate nursing intervention. May also require continuous cardiac monitoring depending on the degree of electrolyte imbalances

Nursing care revolves around electrolyte replacement and patient teaching. The nurse must remind the patient that therapy for hypoparathyroidism is lifelong, and advise the patient to wear a medical-alert bracelet. Also teach the patient to eat foods high in calcium, but low in phosphorus. {Milk, yogurt, and processed cheeses = high in phosphorus, and are NOT advised}

Administration of drugs or dyes containing iodine Childbirth (immediately postpartum) Congestive heart failure DKA Inadequate hormone replacement Infection Pulmonary embolism Severe emotional distress Stroke Trauma or surgery (thyroidectomy)

Sudden and extreme elevation of all body processes. Temperature may rise to 106 F or more, pulse can increase to as much as 200 bpm, respirations become rapid, patient exhibits marked apprehension and restlessness. If condition is left untreated, patient can quickly passes from delirium to coma, to death from heart failure.

Treat IMMEDIATELY after symptoms are noticed, rather than waiting for lab conformation. Measures taken to reduce temperature, cardiac drugs to slow the heart rate, sedatives, such as barbiturate are given to reduce anxiety and restlessness. {Asprin should NEVER be given during this episode, because it increases serum levels T3 & T4}