7 Hyperthyroidism Nursing Care Plans

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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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  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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Deficient Knowledge

Nursing Diagnosis

May be related to

  • Lack of exposure/recall
  • Information misinterpretation
  • Unfamiliarity with information resources

Possibly evidenced by

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  • Questions, request for information, statement of misconception
  • Inaccurate follow-through of instructions/development of preventable complications

Desired Outcomes

  • Client will verbalize understanding of disease process and potential complications.
  • Client will identify the relationship of signs/symptoms to the disease process and correlate symptoms with causative factors.
  • Client will verbalize understanding of therapeutic needs.
  • Client will initiate necessary lifestyle changes and participate in the treatment regimen.
Nursing InterventionsRationale
Review the disease process and future expectations.Provides knowledge base from which patient can make informed choices.
Provide information appropriate to individual situation.This information includes the severity of the condition, cause, age, and concurrent complications to determine the course of treatment.
Identify stressors and discuss precipitators to thyroid crises: personal or social and job concerns, infection, pregnancy.Psychogenic factors are often of prime importance in the occurrence and/or exacerbation of this disease.
Provide information about signs and symptoms of hypothyroidism and the need for continuous follow-up care.A patient who has been treated for hyperthyroidism needs to be aware of the possible development of hypothyroidism, which can occur immediately after treatment or as long as 5 yr later.
After 131I therapy, tell the patient not to expectorate or cough freely. Stress need for repeated measurement of serum T4 levels.Saliva will be radioactive for 24 hours.
Monitor CBC periodically.To detect leukopenia, thrombocytopenia, and agranulocytosis if the patient is taking propylthiouracil and methimazole. Instruct to take medications with meals to minimize GI distress and to avoid OTC cough preparations because many contain iodine.
Discuss drug therapy, including the need for adhering to the regimen, and expected therapeutic and side effects.Antithyroid medication (either as primary therapy or in preparation for thyroidectomy) requires adherence to a medical regimen over an extended period to inhibit hormone production. Agranulocytosis is the most serious side effect that can occur, and alternative drugs may be given if problems arise.
Identify signs and symptoms requiring medical evaluation: fever, sore throat, and skin eruptions.Early identification of toxic reactions (thiourea therapy) and prompt intervention are important in preventing the development of agranulocytosis.
Explain the need to check with a physician and/or pharmacist before taking other prescribed or OTC drugs.Antithyroid medications can affect or be affected by numerous other medications, requiring monitoring of medication levels, side effects, and interactions.
Emphasize the importance of planned rest periods.Prevents undue fatigue; reduces metabolic demands. As euthyroid state is achieved, stamina and activity level will increase.
Review need for a nutritious diet and periodic review of nutrient needs. Tell patient to avoid caffeine, red/yellow food dyes, artificial preservatives.Provides adequate nutrients to support the hypermetabolic state. A hormonal imbalance is corrected, the diet will need to be readjusted to prevent excessive weight gain. Irritants and stimulants should be limited to avoid cumulative systemic effects.
Stress necessity of continued medical follow-up.Necessary for monitoring the effectiveness of therapy and prevention of potentially fatal complications.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans related to endocrine system and metabolism disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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