7 Hyperthyroidism Nursing Care Plans

Updated on May 5, 2019

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:

Risk for Impaired Tissue Integrity

Risk for Impaired Skin Integrity: At risk for altered epidermis and/or dermis.

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.
Diuretics	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.