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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 Plans
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:
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- Risk for Decreased Cardiac Output
- Fatigue
- Risk for Disturbed Thought Processes
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Anxiety
- Risk for Impaired Tissue Integrity
- Deficient Knowledge
- Other Possible Nursing Care Plans
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Anxiety
Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.
May be related to
- Physiological factors: hypermetabolic state (CNS stimulation), pseudo catecholamine effect of thyroid hormones
Possibly evidenced by
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- Increased feelings of apprehension, shakiness, loss of control, panic
- Changes in cognition, distortion of environmental stimuli
- Extraneous movements, restlessness, tremors
Desired Outcomes
- Client will appear relaxed.
- Client will report reduced anxiety to a manageable level.
- Client will identify healthy ways to deal with feelings.
| Nursing Interventions | Rationale |
|---|---|
| Observe behavior indicative of the level of anxiety. | Mild anxiety may be displayed by irritability and insomnia. Severe anxiety progressing to the panic state may produce feelings of impending doom, terror, inability to speak or move, shouting or swearing. |
| Monitor physical responses, noting palpitations, repetitive movements, hyperventilation, insomnia. | Increased number of [beta]-adrenergic receptor sites, coupled with effects of excess thyroid hormones, produce clinical manifestations of catecholamine excess even when normal levels of norepinephrine or epinephrine exist. |
| Stay with the patient, maintaining a calm manner. Acknowledge fear and allow the patient’s behavior to belong to the patient. | Affirms to patient or SO that although patient feels out of control, environment is safe. Avoiding personal responses to inappropriate remarks or actions prevents conflicts or overreaction to a stressful situation. |
| Describe and explain procedures, surrounding environment, or sounds that may be heard by the patient. | Provides accurate information, which reduces distortions and confusion that can contribute to anxiety and/or fear reactions. |
| Speak in brief statements. Use simple words. | Attention span may be shortened, concentration reduced, limiting the ability to assimilate information. |
| Reduce external stimuli: Place in a quiet room; provide soft, soothing music; reduce bright lights; reduce the number of persons having contact with the patient. | Creates a therapeutic environment; shows recognition that unit activity or personnel may increase patient’s anxiety. |
| Discuss with patient and/or SO reasons for emotional lability and/or psychotic reaction. | Understanding that behavior is physically based enhances acceptance of the situation and encourages different responses and approaches. |
| Reinforce the expectation that emotional control should return as drug therapy progresses. | Provides information and reassures patient that the situation is temporary and will improve with treatment. |
| Administer antianxiety agents or sedatives and monitor effects. | May be used in conjunction with a medical regimen to reduce effects of hyperthyroid secretion. |
| Refer to support systems as needed: counseling, social services, pastoral care. | Ongoing therapy support may be desired or required by patient/SO if crisis precipitates lifestyle alterations |
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Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023Â (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans related to endocrine system and metabolism disorders:
- 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 2Â | 17 Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)Â | 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
Nyc
Super post. Do you have any other ones you can give? I like super stuff. :)
This content has really improved my knowledge about hyperthyroidism. Thank you so much