7 Thyroid, parathyroid and adrenal disorders.docx - Lecture Notes NURS 360 Disorders of the Thyroid Parathyroid and Adrenal Glands Hyperthyroidism An

7 Thyroid, parathyroid and adrenal disorders.docx - Lecture...

This preview shows page 1 - 4 out of 14 pages.

Lecture Notes NURS 360 Disorders of the Thyroid, Parathyroid and Adrenal Glands Hyperthyroidism An overproduction of T 4 (thyroxine) and/or T 3 (triiodothyronine) by thyroid gland o 20/1 ratio T4 to T3 o T3 more active Occurs more often in women Highest frequency in 20- to 40-year-olds Most common: 75% of all cases Graves’ disease (autoimmune) Other causes Thyroiditis (postpartum) Toxic nodular goiter (Plummer’s disease) Exogenous iodine excess Amiodarone (antiarrhythmic medication- commonly used in atrial fibrillation to slow ventricular rate) Thyroid cancer Laboratory diagnosis Low TSH (thyroid stimulating hormone) Elevated T 4 and /or T 3 Free T 4 is preferable to total T 4 Radioactive iodine I-131 or 1-123 uptake (RAIU) and scan o High uptake: Graves, Multinodular goiter o Low uptake: Thyroiditis, Amiodarone (antiarrhythmic used to tx AF) Thyroid Function Tests Thyroid stimulating hormone (TSH) : 0.4-6 µU/mL Thyroxine, free (FT 4 ) : 9-24 pmol/L Thyroxine, total (T 4 ) : 5-11 µg/dL Triiodothyronine, total (T 3 ) : 95-190 ng/dL Diagnostic Studies History Physical examination Ophthalmologic examination ECG Radioactive iodine uptake (RAIU) o Indicated to differentiate Graves’ disease from other forms of thyroiditis Clinical Manifestations: Assessment Related to effect of thyroid hormone excess 1
Image of page 1

Subscribe to view the full document.

Lecture Notes o ↑ Metabolism o ↑ Tissue sensitivity to stimulation by sympathetic nervous system Elderly: more subtle s/s: weight loss, depression, or atrial fibrillation Ophthalmopathy Abnormal eye appearance or function Exophthalmos o Protrusion of eyeballs from the orbits Impaired drainage from orbit Increased fat and edema in retroorbital tissues Seen in 20% to 40% of patients Gland is enlarged and smooth; may have an overlying bruit Cardiovascular system Bruit over thyroid gland Systolic hypertension ↑ Cardiac output Dysrhythmias Cardiac hypertrophy 2
Image of page 2
Lecture Notes Atrial fibrillation GI system ↑ Appetite, thirst Weight loss Diarrhea Splenomegaly Hepatomegaly Integumentary system Warm, smooth, moist skin Thin, brittle nails Hair loss Clubbing of fingers Diaphoresis Vitiligo Musculoskeletal system Fatigue (eventually) Muscle weakness Proximal muscle wasting Dependent edema Osteoporosis Nervous system Fine tremors Insomnia Ability of mood, delirium Hyperreflexia of tendon reflexes Inability to concentrate Reproductive system Menstrual irregularities Amenorrhea Decreased libido Impotence Gynecomastia in men Decreased fertility Intolerance to heat ↑ Sensitivity to stimulant drugs Elevated basal temperature Which laboratory values alteration would you expect in Graves disease?
Image of page 3

Subscribe to view the full document.

Image of page 4
  • Spring '16
  • Kim McCarron

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Ask Expert Tutors You can ask You can ask ( soon) You can ask (will expire )
Answers in as fast as 15 minutes