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Outline
Overview
Pathophysiology
Hyperthyroidism is the overproduction of the hormone thyroxine by the thyroid gland. This hormone speeds up the body’s metabolism, causing sudden weight loss, and can result in a fast or irregular heart rate. Often, inflammation and edema can result in exophthalmos (protrusion of the eyes). Treatment is medications and/or surgery to remove all or part of the thyroid gland. The symptoms of hyperthyroidism are similar to other health problems and may go undetected for some time.
Etiology
The most common cause of hyperthyroidism is an autoimmune disease called Grave’s disease, where the body makes an antibody (TSI) that stimulates the thyroid gland to produce too much thyroid hormone (TSH). This disorder is considered somewhat hereditary as it is often found running in families. Other causes include nodules (goiter) or inflammation of the thyroid that cause it to produce excess TSH. A less common cause is excessive intake or medications that contain iodine.
Desired Outcome
Maintain adequate cardiac output, decreased fatigue and optimal skin integrity
Hyperthyroidism Nursing Care Plan
Subjective Data:
- Increased appetite
- Nervousness
- Nausea
- Changes in menstrual patterns
- Increased sensitivity to heat
- Fatigue
- Difficulty sleeping
- Sudden weight loss
- More frequent bowel movements
Objective Data:
- Enlarged thyroid gland (goiter)
- Tachycardia
- Vomiting
- Diarrhea
- Sweating
- Tremor
- Thinning skin
- Fine, brittle hair
- Low TSH level with elevated Free T4 level
Nursing Interventions and Rationales
- Monitor vitals, including orthostatic BP assessment and pulse / heart rate during sleep
- Orthostatic hypotension can occur as a result of increased metabolism and excessive peripheral vasodilation.
- Assessing the pulse during sleep can give a more accurate measure of tachycardia.
- Perform 12-lead ECG and monitor
- Assess respiratory status and auscultate lungs for adventitious breath sounds; take note of any history of asthma
- Encourage eye protection and eye drops.
- Monitor daily food intake; incorporate daily weights
- Avoid foods that cause loose stools or increased peristalsis; incorporate extra calories, protein, carbs and vitamins into 6 small meals throughout the day
- Prepare patient for surgery and monitor patient after surgery for swallowing and excessive bleeding.
References
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