Hey everyone, it's Mike here from simple nursing.com. Today we're tackling hyperyroidism versus hypothyroidism, making it super simple with key differences and memory tricks to help it stick. And for all my Simple Nursing members, be sure to grab these two study guides and let's get into it. By the end of this video, you'll be ready to crush those Enclelex questions. So, how are we going to do this, guys? The easiest way is to let the name help you. So think thigh in thyroid is like a thigh master. 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 gains 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. All right guys, now a little bit of pathophysiology that the enclelex expects you guys to know. But let's be honest, the enclelex is never going to 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 TR, 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 calcetonin which basically puts a ton of calcium into the bone. So our memory trick is it tones down the calcium in the blood by putting a ton of calcium into the bone. So calcetone in 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 T3 and T4 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 our high T3 and T4 and hyperthyroidism guys? The number one cause is our autoimmune disease. We talked about Graves disease. We think gains disease in high thyroid but also too much iodine means too much thyroid hormone and even treating hypothyroid conditions. Guys, if we give those patients too much thyroid meds like levothyroxine, 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 seessaw. hyper will be the exact opposite than hypo. So low T3 and T4 in our hypo comes from that autoimmune disease guys called Hashimotos 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 thyroid ectomy 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 enclelex 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 enclelex 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 going to be the exact opposite, guys, low and slow. Make sure to pull out this study guide for this section so you can follow the key points. So for hyper thyroid, guys, that Graves disease, our Gaines disease, everything is super high. We're going to 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, enclelex 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 two G's for graves disease. So the first G is for grape eyes. Now the enclelex term is exoplamus guys. These are big eyeballs that are popping out like big grapes. So think exo and exothalamus 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 enlex. I know it's super weird but always an Enclelex key term. And our second G is for golf balls in the throat called a goer. Guys, this will look like a big bullfrog looking throat. And now everything else will be high. So we'll have high blood pressure aka hypertension. Remember over 140 the heart says oh lordy. We'll also see high heart rate guys known as tacoc cardia over 100. Heart palpitations we'll even see atrial fibrillation. Now, we'll also see high weight loss. And guys, the ENLEX 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 diapharesis. Guys, not dry skin, sweaty skin. Now, this is also called heat intolerance. You will definitely see this on SATA Enclelex questions. And the very last thing we have a high GI so we get diarrhea not constipation. So guys patients in hyper mode 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 enclelex key term. And guys we also do the three big no nos for the enclelex. No high fiber. We need low fiber unless the patient's constipated. Also, no caffeine. So, no coffees, sodas or teas. And lastly, no spicy food. Okay. Now, on the other side in our hypo, our Hashimotos, 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 myoxidemakoma, guys. extremely low respiratory rate. So we think respiratory failure. Again, the priority is innovation supplies at the bedside. Enclelex's key word here is endotraccheial inhabation set or tracheosttomy setup. So we're expecting extremely low BP aka hypotension, extremely low heart rate known as brada cardia below 60 and even low temperature called cold intolerance. Now the enclelex tip here is no electric blankets guys. This can actually harm the patient if they're not closely monitored. Now two more enclelex tips which are the biggest risk for mixademic. Usually after a thyroid removal like a thyroidctomy or abruptly stopping thyroid replacement hormones like levothyroxine. Usually those two lead to the mixedoma the extreme low and slow. Now classic signs for our hypothyroidism. Guys, everything's going to be low and slow. Now, these will show up on SATA select all the apply questions. So, guys, just think everything's going to 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 gain. There will be edema in 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 alopecia. Now guys, this is not her suitism. Huge enclelex tip. They're going to try and trick you. Here's that hairy suit. We have hair loss here. We also have low mental status or basically forgetfulness. Low mood known as depression, apathy or confusion. Low libido with low sex drive or infertile and also slow dry skin trigger. Huge enclelex tape here guys. Not hot, not sweaty, hypo. We have that dry skin. Now our last two enclelex keywords for low and slow. This is what's called irregular menration guys. So we have no periods or basically a missed period. So for a no period it's called amenorhea. So just think amen no period. Now for low but heavy periods we call it hypermenora. So just think hyper menistration 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 enclelex tip right there. Now guys, the most common enclelex 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 my coma guys, we put that ination tray or the endotrachial setup 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 psytolic 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. If you want more tips and tricks for questions like the ones you just walked through, our simple nursing membership has exit prep lectures and thousands of questions on every nursing school and enclelex topic written by current professors and enclelex writers. Now, pharmarmacology and surgeries, always enclelex favorites here, guys. Guys, grab your notes, grab your study guides that we provide. We're going to be covering only the highly tested enclelex topics here. So, meds for hypothyroidism. Guys, we only have one main drug that you need to know for the enclelex and for your nursing exams. It's called levothyroxine, which leaves T3 and T4 in the body. So guys, think levo we give for hypothyroidism. Now, our second memory trick for those SATA questions is just the acronym Levo. 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. E 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 levante 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 we're looking for are 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- nos 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 myexademma coma. Now, some common enlex questions that will try and trick you guys. It's going to give you satic questions. For example, additional patient teaching is needed when the patient on levo says it doesn't work after 18 days. Guys, teach it a slow onset, 3 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 will finally cure me, 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 benzo which are sedatives. These drugs can actually add to the low and slow dropping us into low condition that myexmakoma. Okay, so now the pharmarmacology for hyperthyroidism that Graves disease or our gains 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 four drugs you need to know methosol guys is not baby safe but its friend PTU propathyl uricil 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, SSKI or potassium iodide guys the memory trick is SSK. S for shrinks the thyroid before thyroid removal or basically thyroid ectomy. This is done to reduce the bleeding aka reduce the vascularity. S is for stains the teeth. So guys, drink it through a straw with some juice. And K is to keep it one hour apart from other antiyroid 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 propanol. So, think the double L's and LOLers 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, Riu, 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 enclelex select 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 in the enclroid meds. And guys, yes, you're awake. There's no anesthesia. There's no conscious sedation. So, we're just NPO 2 to four hours before and 1 to two hours after. Guys, it's not 12 hours and it's 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 1 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. 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 thyroid ectomy. Now a lot of enlex tips come from this section. So please write this down. Since thyroid ectomy are usually done for hyperyroidism, 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 enlex priorities, we have the ABCs of thyroid ectomy. A is for airway. Since surgery is done near the neck, guys, we think airway. Huge enclelex key terms here. Write these down. Largeal strider, noisy breathing, and even horarsseness or weak voice. Huge big enlex key terms there. These usually indicate an airway problem. So the number one priority is endotracheial tube at bedside. Now the enclelex will call it different things like innovation supplies and even tracheosttomy setup. So anything with the word tra in it guys keep it at the bedside huge on the enlex. Now B is for breathing that is noisy like covered before laryngal 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 enlex 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, guys. Head of the bed 30 to 45° aka semifallers. And lastly, guys, big no for flexing. This a no flex zone for sure. No extending the neck. huge and always on the enclelex. Now our last C which is another ENLEX favorite guys calcium that is low below 8.6 known as hypocalcemia. Now guys these numbers are based on enclelex standards. So your textbook and your school might differ. So memory trick is if you remove the tea then you 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 circumoral tingling around the mouth and even the fingers. And the two other key words are TN for low calcium. So trus, which is basically that arm twerk with the blood pressure cuff on and chioastics, that cheeky smile with facial numbness. So guys, I call these the two dance moves of low calcium. So remember, if you move the tea, then check the C. Thanks for watching. Did you know you can unlock beautifully handcrafted study guides packed with key points and memory tricks from all our videos? Plus, you'll get access to over,200 exclusive videos not on YouTube, all neatly organized by nursing school topic to make that complex nursing knowledge actually stick. You'll also gain thousands of practice questions written by current professors and actual enclelex writers. So, for access to all this and more, click right up here or visit simplening.com. And don't forget to subscribe to our YouTube channel. Happy studying and we'll see you in the next videos.