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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Risk for Impaired Tissue Integrity

Nursing Diagnosis

Risk factors may include

  • Alterations of protective mechanisms of eye: impaired closure of eyelid/exophthalmos

Possibly evidenced by

  • Not applicable. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.

Desired Outcomes

  • Client will maintain moist eye membranes, free of ulcerations.
  • Client will identify measures to provide protection for eyes and prevent complications.
Nursing Interventions Rationale
Encourage the use of dark glasses when awake and taping the eyelids shut during sleep as needed. Suggest the use of sunglasses or eyepatch. Moisten conjunctiva often with isotonic eye drops. Protects exposed cornea if the patient is unable to close eyelids completely because of edema or fibrosis of fat pads and/or exophthalmos.
Elevate the head of the bed and restrict salt intake if indicated. Decreases tissue edema when appropriate: HF, which can aggravate existing exophthalmos.
Instruct patient in extraocular muscle exercises if appropriate. Improves circulation and maintains mobility of the eyelids.
Provide an opportunity for the patient to discuss feelings about altered appearance and measures to enhance self-image. Protruding eyes may be viewed as unattractive. Appearance can be enhanced with proper use of makeup, overall grooming, and use of shaded glasses.
Administer medications as indicated:
  • Methylcellulose drops
 Lubricates the eyes, reducing the risk of lesion formation.
  • Adrenocorticotropic hormone (ACTH), prednisone
 Given to decrease rapidly progressive and marked inflammation.
  • Antithyroid drugs
 May decrease signs and symptoms or prevent worsening of the condition.
Can decrease edema in mild involvement.
Prepare for possible surgery as indicated. Eyelids may need to be sutured shut temporarily to protect the corneas until edema resolves (rare) or increasing space within sinus cavity and adjusting musculature may return the eye to a more normal position.
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See Also

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Endocrine and Metabolic Care Plans

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