Hypothyroidism is a condition classified by an under-active thyroid gland- when the thyroid does not produce enough hormones. It occurs primarily in women in 30 to 60 years old. If severe hypothyroidism occurs in an infant, it is called cretinism. If it developed in an adult, it is called myxedema. The most common cause of hypothyroidism is an autoimmune inflammation of the thyroid gland (Hashimoto’s thyroiditis) with resulting atrophy of glandular tissue. Hypothyroidism also commonly occurs in clients with previous hyperthyroidism that has been treated with radioiodine or antithyroid medications or thyroidectomy.
Nursing Care Plans
The nursing care plan for clients with hypothyroidism includes providing information about disease process/prognosis and therapy needs, guiding the client to meet their nutritional requirement, planning activities with a rest period, and preventing complications.
Here are three (3) nursing care plans (NCP) and nursing diagnosis for patients with hypothyroidism:
Imbalanced Nutrition: More Than Body Requirements
Nursing Diagnosis
May be related to
- Greater intake than metabolic needs.
Possibly evidenced by
- Decreased appetite.
- Sedentary activity level.
- Weight gain.
Desired Outcomes
- Client will maintain a stable weight and takes in necessary nutrients.
Nursing Interventions | Rationale |
---|---|
Assess the client’s weight. | Due to excess fluid volume and low basal metabolic rate, clients with hypothyroidism experience weight gain and difficulty losing extra weight |
Assess the client’s appetite. | Clients with hypothyroidism have decreased appetite. This opposite relationship between weight gain and decreased appetite is a manifestation finding in hypothyroidism. |
Provide a food diary to the client. | Looking into the client’s food intake over the 24 hours will provide baseline data for an individualized nutritional plan for the client’s changing metabolic needs. |
Educate the client and family regarding body weight changes in hypothyroidism. | Teaching the client and family will make them understand the opposite relationship between appetite and weight gain in hypothyroidism. During the start of the thyroid hormone replacement therapy, the client can experience loss of weight. However, there will be an increase in appetite. This change may require a calorie controlled diet to prevent additional weight gain. |
Collaborate with a dietician to determine client’s caloric needs. | The dietician can calculate the appropriate caloric requirements to maintain nutrient intake and achieve a stable weight. |
Encourage the client to eat six small meals throughout the day. | This will make sure that the client has an adequate intake of nutrients in the client with decreased energy levels. |
Provide assistance and encouragement as needed during mealtime. | Due to a decrease in energy levels, the client will need support to ensure the adequate intake of essential nutrients. |
Encourage the intake of foods rich in fiber. | Hypothyroidism slows the action of the digestive tract causing constipation. |
Encourage the client to follow a low-cholesterol, low-calorie, low-saturated-fat diet. | When thyroid hormone levels are low, the body doesn’t break down and remove bad cholesterol as efficiently as usual; Also, since the client has a slow metabolism, he/she requires fewer calories to support the metabolic need |
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
Should one massage the edema in a person with Myxedema? If so, how?