Patho Patho #1

Question

The nurse is conducting teaching regarding the pathophysiology of the development of goiter in clients with Grave’s disease. How does the nurse best explain this to the client?

Answers

  1. “In clients with Grave’s, the immune system causes the thyroid to over-produce its hormones leading to enlargement of the gland.”
    • Rationale:

      This answer is correct because in clients with Graves disease, the thyroid gland becomes over stimulated and overworked which leads to the development of a goiter. A goiter is the enlargement of the thyroid gland which is the response of the thyroid to overstimulation by autoantibodies.

  2. “Because the thyroid does not produce enough of its hormones, it becomes over-stimulated by the pituitary gland causing it to enlarge.”
    • Rationale:

      This answer is not correct because Grave’s disease causes an overstimulation of the thyroid and an overproduction of T3 and T4. Grave’s disease does not cause an underproduction of its hormones.

  3. “In Grave’s disease, the thyroid enlarges due to taking prescribed anti-thyroid medications.”
    • Rationale:

      This answer is not correct because antithyroid medications do not lead to the development of goiter in clients with Grave’s disease. Goiter in these clients is caused by the direct overstimulation of the thyroid by autoantibodies produced by the body’s immune system.

  4. “The thyroid decreases in size due to long term underproduction of thyroid hormones.”
    • Rationale:

      The answer is not correct because goiter is the enlargement of the thyroid as opposed to a decrease in the size of the thyroid. In clients with Grave’s disease, the thyroid enlarges due to prolonged over stimulation by autoantibodies that directly attack the gland.

Overview

Grave’s disease is an autoimmune disorder in which the immune system produces antibodies against the thyroid gland. The focus of this question is for the nurse to instruct on the pathophysiological processes that lead to the development of a goiter in clients with Grave’s.

Explanation

Learning Outcomes

Clients with Grave’s disease produce autoantibodies that directly attack the thyroid gland causing overstimulation and overproduction of thyroid hormones. The overstimulation of the thyroid to produce T3 and T4 causes the gland to become overworked causing it to enlarge in appearance. Enlargement of the thyroid gland is referred to as goiter which is a classic manifestation of Grave’s disease.

Test Taking Tip

In order to answer questions like these correctly, it is essential to know the definition of the manifestation in question. When studying pathophysiology, make sure to really focus on the classic manifestations of disease processes as opposed to memorizing the definitions of all signs/symptoms associated with a disease process.

Video Rationale