Hyperthyroidism, also known as Grave’s disease, Basedow’s disease, or thyrotoxicosis is a metabolic imbalance that results from overproduction of thyroid hormones triiodothyronine (T3) and thyroxine (T4). The most common form is Graves’ disease, but other forms of hyperthyroidism include toxic adenoma, TSH-secreting pituitary tumor, subacute or silent thyroiditis, and some forms of thyroid cancer.
Thyroid storm is a rarely encountered manifestation of hyperthyroidism that can be precipitated by such events as thyroid ablation (surgical or radioiodine), medication overdosage, and trauma. This condition constitutes a medical emergency.
Nursing care management for patients with hyperthyroidism requires vigilant care to prevent acute exacerbations and complications.
Here are seven (7) nursing care plans (NCP) and nursing diagnosis for patients with hyperthyroidism:
- Risk for Decreased Cardiac Output
- Risk for Disturbed Thought Processes
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Risk for Impaired Tissue Integrity
- Deficient Knowledge
- Other Possible Nursing Care Plans
Fatigue: An overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work at usual level.
May be related to
- Hypermetabolic state with increased energy requirements
- Irritability of central nervous system (CNS); altered body chemistry
Possibly evidenced by
- Verbalization of overwhelming lack of energy to maintain the usual routine, decreased performance
- Emotional lability/irritability; nervousness, tension
- Jittery behavior
- Impaired ability to concentrate
- Client will verbalize increase in the level of energy.
- Client will display improved ability to participate in desired activities.
|Monitor vital signs, noting pulse rate at rest and when active.||Pulse is typically elevated and, even at rest, tachycardia (up to 160 beats/min) may be noted.|
|Note development of tachypnea, dyspnea, pallor, and cyanosis.||O2 demand and consumption are increased in the hypermetabolic state, potentiating the risk of hypoxia with activity.|
|Provide for a quiet environment; cool room, decreased sensory stimuli, soothing colors, quiet music.||Reduces stimuli that may aggravate agitation, hyperactivity, and insomnia.|
|Encourage patient to restrict activity and rest in bed as much as possible.||Helps counteract effects of increased metabolism.|
|Provide comfort measures: touch therapy or massage, cool showers. Patient with dyspnea will be most comfortable sitting in high Fowler’s position.||May decrease nervous energy, promoting relaxation.|
|Provide for diversional activities that are calming, e.g., reading, radio, television.||Allows for use of nervous energy in a constructive manner and may reduce anxiety.|
|Avoid topics that irritate or upset patient. Discuss ways to respond to these feelings.||Increased irritability of the CNS may cause the patient to be easily excited, agitated, and prone to emotional outbursts.|
|Discuss with SO reasons for fatigue and emotional lability.||Understanding that the behavior is physically based may enhance coping with the current situation and encourage SO to respond positively and provide support for the patient.|
|Administer medications as indicated: Sedatives such as phenobarbital (Luminal); antianxiety agents; chlordiazepoxide (Librium)||Combats nervousness, hyperactivity, and insomnia.|
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Endocrine and Metabolic Care Plans
Nursing care plans related to the endocrine system and metabolism:
- Acid-Base Balance
- - Respiratory Acidosis Nursing Care Plan
- - Respiratory Alkalosis Nursing Care Plan
- - Metabolic Acidosis Nursing Care Plan
- - Metabolic Alkalosis Nursing Care Plan
- Addison's Disease | 3 Care Plans
- Cushing’s Disease | 6 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Diabetes Mellitus Type 2 | 13+ Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 4 Care Plans
- Eating Disorders: Anorexia & Bulimia Nervosa | 7 Care Plans
- Fluid and Electrolyte Imbalances | 10 Care Plans
- - Fluid Balance: Hypervolemia & Hypovolemia
- - Potassium (K) Imbalances: Hyperkalemia and Hypokalemia
- - Sodium (Na) Imbalances: Hypernatremia and Hyponatremia
- - Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia
- - Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperthyroidism | 7 Care Plans
- Hypothyroidism | 3 Care Plans
- Obesity | 4 Care Plans
- Thyroidectomy | 5 Care Plans