{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}


Info iconThis preview shows pages 1–3. Sign up to view the full content.

View Full Document Right Arrow Icon
HYPERTHYROIDISM (THYROTOXICOSIS, GRAVES’ DISEASE) Hyperthyroidism is a metabolic imbalance that results from overproduction of the thyroid hormones triiodothyronine (T 3 ) and thyroxine (T 4 ). 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. CARE SETTING Most people with classic hyperthyroidism rarely need hospitalization. Critically ill patients, those with extreme manifestations of thyrotoxicosis plus a significant concurrent illness, require inpatient acute care on a medical unit. RELATED CONCERNS Heart failure: chronic Psychosocial aspects of care Thyroidectomy Patient Assessment Database Data depend on the severity/duration of hormone imbalance and involvement of other organs. ACTIVITY/REST May report: Nervousness, increased irritability, insomnia Muscle weakness, incoordination Extreme fatigue May exhibit: Muscle atrophy CIRCULATION May report: Palpitations Chest pain (angina) May exhibit: Dysrhythmias (atrial fibrillation); gallop rhythm, murmurs Elevated BP with widened pulse pressure Tachycardia at rest Circulatory collapse, shock (thyrotoxic crisis) ELIMINATION May report: Urinating in large amounts Stool changes; diarrhea EGO INTEGRITY May report: Recent stressful experience, e.g., emotional/physical May exhibit: Emotional lability (mild euphoria to delirium); anxiety/depression FOOD/FLUID May report: Recent/sudden weight loss Increased appetite; large meals, frequent meals; thirst Nausea/vomiting May exhibit: Enlarged thyroid; goiter Nonpitting edema, especially in pretibial area NEUROSENSORY May exhibit: Rapid and hoarse speech
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Mental status and behavior alterations, e.g., confusion, disorientation, nervousness, irritability, delirium, frank psychosis, stupor, coma Fine tremor in hands; purposeless, quick, jerky movements of body parts Hyperactive DTRs Paralysis (thyrotoxic hypokalemia) PAIN/DISCOMFORT May report: Orbital pain, photophobia (eye movement) RESPIRATION May report: Difficulty breathing May exhibit: Increased respiratory rate, tachypnea Breath sounds: Crackles, wheezes (pulmonary edema associated with thyrotoxic crisis) SAFETY May report: Heat intolerance, excessive sweating Allergy to iodine (may be used in testing) May exhibit: Elevated temperature (above 100° F), diaphoresis Skin smooth, warm, and flushed; hair fine, silky, straight Exophthalmos, lid retraction; conjunctival irritation, tearing Pruritic, erythematous lesions (often in pretibial area) that become brawny SEXUALITY May report: Decreased libido Hypomenorrhea, amenorrhea Impotence TEACHING/LEARNING May report: Family history of thyroid problems History of hypothyroidism, thyroid hormone replacement therapy or antithyroid therapy,
Background image of page 2
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}