HYPERTHYROIDISM: hypersecretion of thyroid hormone

Toxic multinodular Goiter

Causes

tumours of the ovaries or testes

excessive iodine

mild tumours of pituitary or thyroid gland

large amounts of tetraiodothyronine taken through dietary supplements or medications

Inflammation of thyroid gland

Thyroid crisis/ storm: complication of hyperthyroidism

Grave's disease

increased levels of thyroxine in the circulation stimulate cell metabolism resulting in an increased metabolic rate

Cardiovascular system give rises to tachycardia and atrial fibrillation

Condition is characterised by a diffuse enlargement of thyroid gland, Goiter

Autoimmune condition where T3&T4 are elevated and FSH decreased

most common condition of hyperthyroidism and more common in female

occur after a long history of goitre

small independent nodules develop and secrete thyroid hormone

objective data

Treatment

Causes

incomplete removal of thyroid gland

complication of surgery where thyroid gland release thyroxine as the gland is being removed

increase of thyroxine circulating in the blood circulation

acute left ventricular failure due to heart system being rapidly overworked

Seizure and restlessness

tachycardia of up to 200 beats per minutes and above

hyperpyrexia of 41 and above

Lugol's Iodine is used if patient present with left ventricular failure as propranolol is not suitable

Hydrate patient with appropriate intravenous infusion fluids

give propranolol as prescribed to reduce heartbeat if the patient is not presenting with cardiac failure

sedatives are used to reduced restlessness

Hypothermic blanket to reduce hyperpyrexia immediately

surgery for thyroidectomy

abnormal eyeball protrusion(exophthalmos) and inability to close or blink

rapid speech and body movements

elevated T3 & T4 blood serum

sleeping pulse of above 80 beats per minute

Nursing Considerations

give iodine solutions as prescribed with fruit juice or milk to improve taste and administer with a straw to avoid staining the teeth

Provide diet high in proteins calories and vitamins

provide glasses to protect eyes from trauma in exophthalmus

discourage caffeine consumption

ensure enough rest, restrict visitors to family members only

provide emotional support to patient and the family

Nurse patient in a well ventilated and quite room

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