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HYPERTHYROIDISM: hypersecretion of thyroid hormone (Causes (tumours of the…
HYPERTHYROIDISM: hypersecretion of thyroid hormone
Toxic multinodular Goiter
occur after a long history of goitre
small independent nodules develop and secrete thyroid hormone
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
objective data
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
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
Treatment
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
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
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
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