Hyperthyroidism Nursing Care Plan and Management

 

Description
  1. Hyperthyroidism is a hyperthyroid state resulting from hypersecretion of thyroid hormones (T3 and T4).
  2. Hyperthyroidism is characterized by an increased rate of body metabolism.
  3. A common cause is Graves’ disease, also known as toxic diffuse goiter.
  4. Clinical manifestations are referred to as thyrotoxicosis.

Hyperthyroidism

Causes

Graves’ disease has an autoimmune derivation and is caused by circulating anti-TSH autoantibodies that displace TSH from the thyroid receptors and mimic TSH by activating the TSH receptor to release additional thyroid hormones. Graves’ disease is also associated with Hashimoto’s disease, a chronic inflammation of the thyroid gland that usually causes hypothyroidism but can also cause symptoms similar to those of Graves’ disease. Thyrotoxicosis has several different pathophysiological causes, including autoimmune disease, functioning thyroid adenoma, and infection.

Assessment
  1. Enlarged thyroid gland (goiter)Hyperthyroidism-Sx
  2. Palpatations, cardiac dysrhythmias, such as tachycardia or atrial fibrillation
  3. Protruding eyeballs (exophthalmos) possibly present
  4. Hypertension
  5. Heat intolerance
  6. Diaphoresis
  7. Weight loss
  8. Diarrhea
  9. Smooth, soft skin and hair
  10. Nervousness and fine tremors of hands
  11. Personality changes
  12. Irritability and agitation
  13. Mood swings
  14. Oligomenorrhea (Irregular menstrual periods in women)
Complications

Thyroid crisis (storm), also called thyrotoxicosis, is a sudden worsening of hyperthyroidism symptoms that may occur with infection or stress. Fever, decreased mental alertness, and abdominal pain may occur. Immediate hospitalization is needed.

Other complications related to hyperthyroidism include:

  • Heart-related complications including:
    • Rapid heart rate
    • Congestive heart failure
    • Atrial fibrillation
  • Increased risk for osteoporosis, if hyperthyroidism is present for a long time
  • Surgery-related complications, including:
    • Scarring of the neck
    • Hoarseness due to nerve damage to the voice box
    • Low calcium level due to damage to the parathyroid glands (located near the thyroid gland)
  • Treatments for hypothyroidism, such as radioactive iodine, surgery, and medications to replace thyroid hormones can have complications.