Problem
A. What are the major functions of the three hormones secreted by the thyroid gland?
a. Thyroxine
b. Triiodothyronine
c. Calcitonin
B. Explain this statement: "Every cell in the body depends upon thyroid hormones for regulation of their metabolism."
1) Hyperthyroidism
a) Compare and contrast hyperthyroidism, thyrotoxicosis, and Graves' disease.
b) What are the major clinical manifestations of hyperthyroidism related to body systems?
c) How does each test assist in the diagnosis of hyperthyroidism? Which is the primary test used to diagnose hyperthyroidism?
i) TSH
ii) Radioactive iodine uptake test
d) What are the actions/purpose of giving and the nursing implications of each?
e) Antithyroid drugs (Indication, Action, Side effects, Nursing considerations, Patient teaching)
i) Propylthiouracil (PTU)
ii) Methimazole (Tapazole)
iii) Iodine
iv) B-adrenergic blockers
f) How is radioactive iodine therapy used in treating hyperthyroidism? What are nursing implications and important concepts to teach the patient? What radiation safety precautions are necessary?
g) When is surgery indicated as treatment for hyperthyroidism? Why is iodine given pre-operatively? What is the nursing care post-operatively? What is the priority concern?
h) Why is the patient with hyperthyroidism placed on a high-calorie, low fiber, decreased seasoning diet? In order to attain this dietary goal, what would the nurse teach the patient?
i) What is acute thyrotoxicosis (thyroid storm)? What is the treatment and nursing care?
j) Discuss the nursing care for the patient with hyperthyroidism.
2) Hypothyroidism
a) Compare and contrast hypothyroidism and myxedema coma.
b) What are the major clinical manifestations related to body systems? How do they compare with hyperthyroidism?
c) How is myxedema coma treated?
d) How does thyroid stimulating hormone (TSH) assist in diagnosing hypothyroidism? Is it increased or decreased?
e) Levothryoxine (Synthroid): What is the indication, action, side effects, nursing considerations, and patient teaching?
f) What are important patient and family teaching points related to hypothyroidism?
3) Hyperparathyroidism
a) What are the clinical manifestations of hyperparathyroidism related to body systems? What are the complications?
b) What diagnostic studies are used to confirm the diagnosis of hyperparathyroidism?
c) What are the criteria for surgical removal of the parathyroid gland? What teaching and nursing care are important?
d) What medications are used in treatment - including indications, actions, side effects, nursing considerations, and patient teaching?
e) What is nursing care for the patient with hyperparathyroidism?
4) Hypoparathyridism
a) What are the clinical manifestations related to body systems?
b) What are Chvostek's sign and Trousseau's sign?
c) What medications are used in treatment - indications, actions, side effects, nursing considerations, and patient teaching? Why is it important to infuse IV calcium gluconate slowly?
d) What measures are used to increase serum calcium?
e) What foods are high in calcium? Why is taking vitamin D important?