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.
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
Imbalanced Nutrition: More Than Body Requirements: Intake of nutrients that exceeds metabolic needs.
May be related to
- Greater intake than metabolic needs.
Possibly evidenced by
- Decreased appetite.
- Sedentary activity level.
- Weight gain.
- Client will maintain a stable weight and takes in necessary nutrients.
|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|
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Endocrine and Metabolic Care Plans
Nursing care plans related to the endocrine system and metabolism:
- 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 2 | 13+ Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 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