Hyperthyroidism vs. Hypothyroid RN LPN NCLEX

hey guys nurse Mike here and welcome to simple nursing comm now before we get today's lecture started please remember to access your free quiz and preview our cool nifty new study guides not here on YouTube click the link right up here at any time during this video all right guys let's begin alright guys let's wrap up hyper versus hypothyroidism guys the easiest way is to let the name help you so think thigh in thyroid is like a ThighMaster you guys use a lot of energy since the thyroids create high energy and high metabolism for the body so guys in hyperthyroidism think high energy and high metabolism now this is also called Graves disease so we call it Gaines disease high and hyper energy now on the other side for hypothyroidism guys we think low and slow energy so start moving your thighs during the exam for Hyper we have high energy and for hypo we have just this low and slow alright guys now a little bit of pathophysiology that the NCLEX expect you guys to know but let's be honest the NCLEX is never gonna ask you a direct question about pathophysiology so as you know just like all endocrine hormones it's a big game of telephone or dominoes if you will so the hypothalamus releases trh which then tells the anterior pituitary to release TSH the thyroid stimulating hormone and can you guess what the thyroid stimulating hormone does well yes guys it stimulates the thyroid oh how stimulating so once stimulated the thyroid pops out three most important key players guys are t3 and t4 which are basically our active thyroid hormones and also calcitonin which basically puts a ton of calcium into the bone so a memory trick is it tones down the calcium in the blood by putting a ton of calcium into the bone so calcitonin a ton in the bone now our thyroid hormones t3 and t4 are the main focus for our thyroid conditions hypo we have low t3 and t4 and hyper we have high eighty-three nt4 and to make this your body needs dietary iodine found in salt so iodine deficiency is a major cause of that hypo low thyroidism in developing countries so what causes are high T 3 and T 4 in hyperthyroidism guys the number one cause is our autoimmune disease we talked about Graves disease we think Gaines disease in high thyroid but also too much iodine means too much thyroid hormone and even treating hypothyroidism which leaves too much thyroid hormones in the body we can eventually cause a hyper condition so guys balancing these two conditions is kind of like a teeter totter or basically like a seesaw hyper will be the exact opposite than hypo so low t3 and t4 in our high bow comes from that autoimmune disease guys called Hashimoto's that low and slow thyroid now other causes are low iodine in the diet and a big one guys big test up here pituitary tumor and even anti-thyroid treatments like a thyroidectomy where we take out that thyroid gland and now the body can't produce any thyroid hormones at all now as far as diagnostic tests guys don't let the NCLEX trick you here so here's a tip always focus on t3 and t4 first guys don't even look at TSH initially if t3 and t4 are high then it's hyper thigh and guys if it's low then it's hypo now you don't have to memorize any of the values the NCLEX will give you the ranges okay now after seeing t3 and t4 then we look at TSH so TSH will always be the opposite of t3 and t4 here guys TSH is just trying to slow the hyper and amp up the hypo so guys as far as signs and symptoms it's super simple everything in hyper will be high and hot and everything in hypo is gonna be the exact opposite guys low and slow so for a hyper thyroid guys that Graves disease are gains ZZZ everything is super-high we're gonna be bouncing off the walls super amped up like you're on a bunch of energy drinks and again the priority is to monitor for this thyroid storm aka thyroid toxicosis guys this will kill the patient again NCLEX key terms are agitation confusion and even restlessness those are usually the first signs coupled with extremely high temperatures over 105 high heart rate and blood pressure now classic signs that will show up on select all that apply questions guys we use our 2 G's for Graves disease so the first G is for grapes term is X up thalamus guys these are big eyeballs that are popping out like big grapes so think EXO and exophthalmos as eyes exiting the body so typically we use an eye patch or even tape down the eyelids for sleeping guys that's always on the NCLEX I know it's super weird but always an NCLEX key term and our second G is for golf balls in the throat called a goiter guys this will look like a big bull frog looking throat and now everything else will be high so we'll have high blood pressure aka hypertension remember over 140 the heart says Aloha T we'll also see high heart rate guys known as tachycardia over a hundred heart palpitations we'll even see atrial fibrillation now we'll also see high weight loss and guys the NCLEX will try and trick you here no we're not talking about weight gain the biggest thing is weight loss so we'll see skinny patients since we have high energy burn we burn a lot of high calories now with that we'll have high hot temperature hot and sweaty skin known as diaphoresis guys not dry skin sweaty skin now this is also called heat intolerance you will definitely see this on Satta NCLEX questions and the very last thing we have a high GI so we get diarrhea not constipation so guys patients and hypermode need a hyper diet with high calories also high protein and carbohydrates now big key word here frequent meals and snacks like six to eight per day huge NCLEX key-term and guys we also do the three big no nose for the NCLEX no high fiber we need low fiber unless the patient's constipated also no caffeine so no coffees so does artis and lastly no spicy food okay now on the other side in our hypo or Hashimoto's guys everything is low and slow so super depressed fat and lethargic so we get the exact opposite from hyper again the extreme priority is the extreme low and slow airway breathing and circulation now the key term is myxedema coma guys extremely low respiratory rate so we think respiratory failure again the priority is innovation supplies at the bedside and collects key word here is endotracheal intubation set or tracheostomy setup so we're expecting extremely low BP aka hypotension extremely low heart rates known as bradycardia below 60 and even low temperature called cold intolerance now the NCLEX tip here is no electric blankets guys this can actually harm the patient if they're not closely monitored now two more NCLEX tips which are the biggest risk for mix edema coma usually after a thyroid removal like a thyroidectomy or abruptly stopping thyroid replacement hormones like levothyroxine usually those to lead to the mix edema coma the extreme low and slow now classic signs for our hypothyroidism guys everything's gonna be low and slow now these will show up on SATA select all the plight questions so guys just think everything's gonna be low and slow we have low energy known as fatigue weakness muscle pains and aches low metabolism meaning we have weight gain and water game there'll be a demon the legs and even under the eyes now the big key word here is not weight loss we have low energy which means low calories burned so guys we have weight gain here we also have low digestion called constipation not diarrhea low hair or basically hair loss called LP now guys this is not hirsutism huge NCLEX tip they're gonna try and trick you hirsutism is that hairy suit we have hair loss here we also have low mental status or basically forgetfulness Lomu known as depression apathy or confusion low libido with low sex drive or infertile and also slow dry skin turgor huge NCLEX tapir guys not hot not sweaty hypo we have that dry skin there are last two NCLEX keywords for low and slow this is what's called irregular menstruation guys so we have no periods or basically a missed period so for a no period it's called amenorrhea so just think a man no period now for low but heavy periods we call it hyper man area so just think hyper menstruation heavy bleeding now for diet and hypo guys we have low energy so we need low calories low cholesterol low saturated fats and since we have low energy we need frequent rest periods guys huge and clicks tip right there now guys the most common and class questions revolve around priority or basically who dies first and it's always the extreme conditions guys for example you will get a question about a client in Hashimoto's with that low heart rate less than 60 or those low respirations about 10 right so we're thinking here myxedema coma guys we put that in a Bayesian tray or the endotracheal set up near the bedside so on the other side of things you get a question about a client in Graves disease guys with high high heart rate like over 100 beats per minute or high blood pressure over 140 systolic and even high temperature like over 101 guys the biggest thing think thyroid storm and the priority here is to monitor for agitation and confusion now pharmacology and surgeries always NCLEX favorites here guys guys grab your notes grab your study guides that we provide we're gonna be covering only the highly tested NCLEX topics here so meds for hypothyroidism guys we only have one main drug that you need to for the NCLEX and for your nursing exams it's called levothyroxine which leaves t3 and t4 in the body so guys think leave oh we give for hypothyroidism now our second memory trick for those SATA questions is just the acronym leave o L for lifelong drug guys we never stop taking this drug these are what's known as forever medications and L for long slow onset usually three to four weeks till we find relief now test questions love to ask patient education on these two points so I'd write those down B is for early morning and empty stomach always 30 to 60 minutes before breakfast one time a day at the same time every day guys never at night levo is always in the morning when you 11th that they're or basically get up now V is for very hyper guys we report signs and symptoms of hyperthyroidism basically high heart rate high BP high temperature it could lead to an extreme condition known as our thyroid storm so key words were looking for our agitation and confusion usually the early signs of a thyroid storm and lastly o is for oh the baby's fine so guys it's pregnancy safe now the four most tested no knows to help drive them the point for the most tested points here guys no food we take an hour before breakfast key word here is empty stomach no cure this medication is a hormone replacement it will never cure it'll only treat so yes this is a forever drug and no double dosing if you ever miss a dose guys take ASAP or as soon as possible and lastly never abruptly stop taking medications key word is abrupt stop it can lead to an extreme hypo low condition with low respiratory rate low BP and guys that will kill your patient again this is called myxedema coma now some common NCLEX questions that will try and trick you guys it's going to give you Sadek questions for example additional patient teaching is needed when the patient on levo says it doesn't work after eighteen days guys teach it's a slow onset three to four weeks like 21 days now the patient 30 weeks pregnant guys is that okay yes it's baby safe and my personal favorite patient states I'm glad this med well finally Curie guys no there's no cure here and a little side note for hypo since everything is low and slow we avoid narcotics or basically opioids like vicodin and other painkillers and guys we avoid benzos which are sedatives these drugs can actually add to the low and slow dropping us into low condition that myxedema coma okay so now the pharmacology for hyperthyroidism that Graves disease or our Gaines disease guys think here the thyroid is super amped up and super high so we need to slow down that thyroid right or basically we need to kill it so the for drugs you need to know methimazole guys is not baby safe but it's friend PTU pro path i'll uracil memory trick for PTU is puts the thyroid underground this guy is baby safe but we report fever and sore throat guys these dudes stop the thyroid from making t3 and t4 basically slow it down now SS k i our potassium iodide guys the memory trick is SS k s4 shrinks the thyroid before thyroid removal or basically thyroidectomy this is done to reduce the bleeding aka reduce the vascularity s is for it stains the teeth so guys drink it through a straw with some juice and k is to keep it one hour apart from other anti thyroid medications lastly since hyper thyroid we have a hyper heart we use beta blockers which puts the brakes on the heart slowing it down now these guys end in lol like propanolol so think that double owls in lol lowers the double heart vitals so low blood pressure and low heart rate now next up guys the most dangerous and consequently the most tested here are a IU radioactive iodine uptake guys these are the big guns it destroys the thyroid in like one dose so we expect hypo low signs and symptoms basically we're monitoring for extreme lows like respiratory failure now again guys it's very toxic making the patient like radioactive so some common and collects select I'll apply questions always come from this section guys write these down before giving we always ensure a pregnancy test is negative we always remove neck jewelry and dentures that one came up a lot on the NCLEX here and five to seven days before giving this drug we hold any anti thyroid meds and guys yes you're awake there's no anesthesia there's no conscious sedation so we're just NPO two to four hours before and one to two hours after guys it's not twelve hours and does not surgery this is just a radioactive pill one dose one and done lasts about 24 to 72 hours and speaking of after we give it guys we avoid everyone up to seven days now most quiz banks say about one to three days so just avoid everyone so no going around pregnant people guys no crowds not even the same restroom we're flushing it three times not even the same food utensils guys and no not the same laundry as your family's separate laundry baskets and lastly no cuddling and not even kissing now lastly guys if all else fails we can do a good old-fashioned surgery known as a thyroidectomy now a lot of NCLEX tips come from the section so please write this down since thyroidectomy are usually done for hyperthyroidism it's kind of like removing a big glass of milk surgeons can accidentally like squeeze out a lot of thyroid hormones into the body so guys we're monitoring for high extreme conditions after surgery known as a thyroid storm okay now for the big NCLEX priorities we have the ABCs of thyroidectomy a is for Airways since surgery is done near the neck guys we think airway huge NCLEX key terms here write these down laryngeal Strider noisy breathing and even hoarseness or weak voice huge big NCLEX key terms there these usually indicate an airway so the number one priority is endotracheal tube at bedside now the NCLEX we'll call it different things like innovation supplies and even tracheostomy setup so anything with the word trach in it guys keep it at the bedside huge on the NCLEX now B is for breathing that is noisy like covered before laryngeal Strider so guys we always monitor voice strength and quality now next C is for circulation obviously we just had the surgery so guys we're looking for bleeding but specifically bleeding around the pillow and insertion site now big NCLEX key terms for positioning to prevent the bleeding guys write these down we want a neutral head and neck alignment this means not supine big no-no guys head of the bed 30 to 45 degrees make a semi Fowler's and lastly guys big no for flexing it's a no flex zone for sure no extending the neck huge and always on the NCLEX now our last C which is another NCLEX favorite guys calcium that is low below 8.6 known as hypocalcemia now guys these numbers are based on NCLEX standards so your textbook and your school might differ so memory trick is if you remove the T then ya check the C or basically if you remove the thyroid then guys check the calcium now the first sign of low calcium write this down tingling and numbness or circumaural tingling around the mouth and even the fingers and the two other key words are T and C for low calcium so true so is which is basically that arm to work with the blood pressure cuff on and shahboz Nick's that cheeky smile with facial numbness so guys I call these the two dance moves of low calcium so remember if you remove the T then check the C alright guys that wraps it up for hyper and hypo thyroidism guys don't forget to take your quiz to test your comprehension thanks for watching for our full video & new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube last but not least a big thanks to our team of experts helping us make these great videos alright guys see you next time [Music] [Music]

Channel: Simple Nursing

Views: 547,793

Rating: 4.8985348 out of 5

Keywords: Thyroid, Hyperthyroidism, Hypothyroidism, Graves disease, Hashimotos Thyroid pharmacology, Synthroid, Levothyroxine, Thyroid pharmacology, Potassium Iodide, radioactive iodine, thyroid gland, thyroid cancer, KI, thyroid storm, thyrotoxicosis, hyperthyroidism, thyroxine, thyroid disease, Antithyroid agents, Registered nurse RN, RN, Osmosis, Pharmacology, NCLEX, ATI exit, HESI exit, simplenursing, simple nursing, Endocrine

Id: YyHM9xQyyas

Length: 20min 14sec (1214 seconds)

Published: Wed Aug 21 2019