7 Hyperthyroidism Nursing Care Plans

By
Matt Vera, BSN, R.N.
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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:

  1. Risk for Decreased Cardiac Output
  2. Fatigue
  3. Risk for Disturbed Thought Processes
  4. Risk for Imbalanced Nutrition: Less Than Body Requirements
  5. Anxiety
  6. Risk for Impaired Tissue Integrity
  7. Deficient Knowledge
  8. 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

  • 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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See Also

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Endocrine and Metabolic Care Plans

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