3 Hypothyroidism Nursing Care Plans

By
Paul Martin, BSN, R.N.
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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:

  1. Imbalanced Nutrition: More Than Body Requirements
  2. Deficient Knowledge
  3. Fatigue

2. Deficient Knowledge

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Deficient Knowledge

Nursing Diagnosis

  • Deficient Knowledge

May be related to

  • Lack of exposure to hypothyroidism.
  • New disease process.
  • Unfamiliarity with information resources.

Possibly evidenced by

  • Limited questioning about hypothyroidism and taking thyroid hormone replacement.
  • Verbalization of lack of information about the disease and its management.

Desired Outcomes

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  • Client and family members will verbalize correct information about hypothyroidism and taking thyroid hormone replacement.
Nursing Interventions Rationale
Assess the client’s knowledge of hypothyroidism and thyroid hormone replacement therapy. Client teaching should begin with the current knowledge about the disease and its management.
Provide information about hypothyroidism. Clients experiencing hypothyroidism may have impaired memory, confusion, hearing loss, and a decreased attention span. These neurologic changes can hinder with learning new information. Teaching sessions should be planned at times when the client is best able to concentrate. Recalling of information is needed to facilitate learning. Using written information reinforces verbal presentation.
Educate the client and family regarding thyroid hormones. Levothyroxine sodium (Synthroid) is a manmade thyroid hormone that is used to treat hypothyroidism.
  • Instruct the client to take the dose in the morning to avoid insomnia.
 Thyroid hormone should be taken on a regular basis to achieve a hormone balance.
  • Instruct the client to take the medication on an empty stomach.
 The client is initially given a small dose that gradually increases until a euthyroid state is achieved. When the thyroid hormone level increases, the client experiences insomnia and weight loss.
  • Teach the expected benefits and possible side effects.
 The client should report symptoms such as chest pain/palpitations; these happen due to the increased metabolic and oxygen consumption.
Emphasized the importance of rest periods. Avoid undue fatigue; As the euthyroid state is achieved, the activity level will eventually increase.
Encourage the client to follow appointments for blood workups (T3, T4, and TSH levels). These levels help determine the effectiveness of pharmacotherapy
Describe the signs and symptoms of over- and underdosage of the medications. This will serve as a check for the client to determine if the therapeutic levels are met.
Encourage the client to have medical identification about hormone therapy and to inform all health care provider. Medical identification provides other health care providers with information to guide decisions about care. Levothyroxine is highly protein bound in circulation. This drug characteristic contributes to many drug interactions. The client needs to notify all health care providers about taking this drug.
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2. Deficient Knowledge

See Also

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Endocrine and Metabolic Care Plans

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Paul Martin, BSN, R.N.
Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.

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