MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERSTHYROID DISORDERS (Hyperthyroidism &Hypothyroidism) Learning Objective On completion of this lecture, the students will be able to: Compare hypothyroidism and hyperthyroidism: their causes, clinical manifestations, management, and nursing interventions.

1. MANAGEMENT OF PATIENTS WITH ENDOCRINE
DISORDERS
THYROID DISORDERS (Hyperthyroidism &Hypothyroidism)
JAMILAH SAAD ALQAHTANI
NURSE LECTURER, MSN, TOT, OR NURSE
SPECIALIST, RGN, BSN

2. THYROID
DISORDERS
Hyperthyroidism
Hypothyroidism
Learning Objective
On completion of this lecture, the
students will be able to:
Compare hypothyroidism and
hyperthyroidism: their causes,
clinical manifestations,
management, and nursing
interventions.

3. Hypothyroidism
 Caused by thyroid hormone deficiency –Triiodothyronine
(T3) and Thyroxine (T4)
 Causes:
◦ Autoimmune – most common
◦ Thyroidectomy
◦ Thyroid atrophy
 Manifestations:
◦ Cold intolerance
◦ Weight gain
◦ Dry skin
◦ Hair loss
◦ Constipation
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THYROID DISORDERS( HYPERTHYROIDISM
& HYPOTHYROIDISM) 3

4. Hypothyroidism
6/13/2020 DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE 4
•Thyroid replacement: give Levothyroxine (Synthroid or Levothroid), PO –
take in the morning without food
•Increase fiber intake
•Warm environment – provide extra blanket
Medical Management:
•Give Levothyroxine, IV, until conscious then change to oral form.
Myxedema Coma – advanced form of hypothyroidism

5. Examples of
nursing
diagnoses
6/13/2020 DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE 5
Activity intolerance related to fatigue
Risk for imbalanced body temperature
related to cold intolerance.
Constipation related to depressed
gastrointestinal function.
Ineffective breathing pattern related to
depressed ventilation.

6. Hyperthyroidism
Excessive thyroid hormone (T3 & T4) secretion
Causes:
◦ Grave’s disease – most common
◦ Thyroiditis
◦ Excessive thyroid hormone intake
Manifestations:
◦ Heat intolerance
◦ Weight loss
◦ Moist skin
◦ Diarrhea
◦ Exophthalmos – bulging eyes
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DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC
HORMONE 6

7. Hyperthyroidism
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•Medical Management:
• Drug Therapy
1. Radioactive Iodine (131I) – to destroy overactive iodine
cells
2. Antithyroid Agents – to stop thyroid hormone synthesis
or release
 most common: propylthiouracil (PTU), methimazole (Tapazole)
3. Lugol’s solution – decrease thyroid hormone release and
decrease vascularity of thyroid gland; give with juice and
straw
4. Propranolol – for symptomatic relief of heat intolerance
DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE 7

8. Hyperthyroidism
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DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC
HORMONE 8
Surgical Management: Thyroidectomy Nursing Management:
If with exophthalmos
• Artificial tears
• Use of dark sunglasses
• Tape eyelids close at night
Cool and quiet environment
• Provide cool baths or cool fluids
Weight monitoring
Fluid replacement

9. Examples of Nursing Diagnoses
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DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC
HORMONE 9
Imbalanced Nutrition:
Less Than Body
Requirements related to
increased metabolic rate.
Ineffective coping
related to irritability
Low self esteem related
to changes in appearance
and weight loss
Altered body
temperature