Hyperthyroidism

• a.k.a Thyrotoxicosis; Overactive thyroid

• is the term for overactive tissue within the thyroid gland, resulting in overproduction and thus an excess of circulating free thyroid hormones: thyroxine (T 4), triiodothyronine
(T3), or both. Thyroid hormone is important at a cellular level, affecting nearly every type of tissue in the body.
• Is a metabolic imbalance that results from overproduction of the thyroid hormones triiodothyronine(T3) and thyroxin(T4).
 Risk Factors
Non-modifiable:
➢ Age(>50) – degeneration that
happens with aging increases
one’s risk for hyperthyroidism.
➢ Gender -- Graves' disease and
hyperthyroidism affect women 8
times more often than men.
➢ Heredity – family history of
hyperthyroidism increases
one’s risk of acquiring the
disorder.
➢ Grave's disease - the most
common cause of
hyperthyroidism, is
characterized by
hyperthyroidism and one or
more of the following:
○ Goiter
○ Exophthalmos
○ Infiltrative dermopathy
Graves' disease is caused by
an autoantibody against the
thyroid receptor for thyroid-
stimulating hormone (TSH);
unlike most autoantibodies,
which are inhibitory, this
autoantibody is stimulatory,
thus producing continuous
synthesis and secretion of
excess T4 and T3.
Assessment Nursing Diagnoses
ACTIVITY/REST: 1. Hyperthermia r/t
hypermatabolic state.
May report: Nervousness, increased
irritability, insomnia, muscle weakness, 2. Decreased cardiac
incoordination, extreme fatigue.
output
May be related to:
May exhibit: Muscle Atrophy
➢ Hypermetabolic rate
➢ increased cardiac
workload
CIRCULATION: ➢ changes in venous return
and systemic vascular
May report: palpitations, chest pain(angina) resistance.
1. Fatigue
May exhibit: dysrhythmias(atrial fibrillation); May be related to:
gallop rhythm, murmurs, elevated BP with
➢ Hypermetabolic state with
widened pulse pressure, tachycardia at rest, increased energy
circulatory collapse, thyrotoxic crisis
requirements.
➢ Altered body chemistry
1. Anxiety
ELIMINATION: May be related to:
➢ Physiologic factors:
May report: urinating in large amounts, Hypermetabolic state
diarrhea (CNS stimulation),
pseudocatecholamine
effect of thyroid
hormones
EGO INTEGRITY:
1. Disturbed thought
process
May report: recent stressful experience, e.g.,
May be related to:
emotional/physical
➢ Physiological changes:
increased CNS
May exhibit: emotional lability (mild euphoria
stimulation/ accelerated
to delirium); anxiety/depression
mental activity.
➢ Altered sleep patterns
Interventions
Nursing:
Primary:
• Advice patients to take caution
on taking medications that are
thyrotoxic e.g. amiodarone and
interferon-α – these drugs are
thyrotoxic and can induce
thyroiditis, patients should be
cautious in taking such
medications esp. if they have
genetic predisposition to
hyperthyroidism.
• Avoid excessive intake of
foods high in iodine e.g.
seafoods.
• Instruct the client to minimize
exposure to stress
Secondary:
➢ Improve nutritional status –
hyperthyroidism affects all body
systems including the GI system.
The appetite is increased but may
be satisfied by several well-
balanced meals of small size,
even up to 6 meals a day.
➢ Maintain normal body