protruding, staring eyes and decreased blinking and eye movements. Visual impairments can occur from optic nerve damage or corneal ulceration if untreated

increased tissue mass in the orbit pushes the eyeball forward and increased sympathetic stimulation affects the eyelids

insufficient iodine supply, infections, or stressful life events can act as precipitating factors when combined with genetic factors

Promote physical exercise to improve muscle tone, cardiovascular system, and increase energy levels. Encourage weight-bearing exercises to maintain bone density

Emphasize the importance of continuing regular appointments with primary care provider to monitor condition

Educate client regarding correct nutrition and the importance of consulting a dietician when considering any changes in diet

Educate client on the effect of stress on condition and demonstrate various relaxation techniques, such as meditation or mindful breathing exercises

Educate client on the nature of their diagnosis to address any knowledge deficits

Provide resources for client regarding high protein/calorie foods that they can incorporate into their diet

Hyperactive bowel; increased peristalsis, diarrhea, increased bowel sounds

differentiates between Grave's disease and other forms of thyroiditis

Grave's disease positive clients will show a diffuse, homogenous uptake of 50-80%

damages or destroys thyroid tissue which limits thyroid hormone secretion

drug therapy and RAI must be attempted prior to this treatment

Monitor daily food intake and complete daily weight checks to report further losses and evaluate effectiveness of intervention

Monitor lab values to evaluate protein and electrolyte levels

Educate client on the need to prevent muscle breakdown and weight loss caused by hypermetabolism. Create meal plan with client which includes several nutritious finger foods full of proteins and calories, and encourage ingesting 6 meals per day

Assess client's food preferences and work with dietician to determine current nutritional status and to gain information that will assist in creating a meal plan

Avoid foods that increase peristalsis and fluids that can cause diarrhea to address impaired absorption

Discuss condition with client's family to educate them on coping mechanisms and supportive strategies for the client

Assess vital signs at baseline and with activity to monitor tachycardia presence

Work with client to identify stressors or environments that increase symptoms (tachycardia, dyspnea, anxiety)

Demonstrate comfort measures such as touch therapy, massage, cool showers, to decrease nervous energy and restlessness

Assess pulse and heart rate while client is sleeping to gain more insight to tachycardia

Observe signs and symptoms of severe thirst, dry mucous membranes, or poor capillary refill to identify possible rapid dehydration

Monitor BP lying, sitting, and standing to determine if orthostatic hypotension occurs, which is likely with decreased circulating volume

Educate client to inform provider immediately if chest pain occurs and investigate promptly if reported as this may indicate increased myocardial oxygen demands or ischemia