1. The document provides information about hyperthyroidism, including its definition, causes, clinical manifestations, diagnosis, and nursing interventions. 2. Hyperthyroidism results from excessive thyroid hormone production and causes increased metabolic rate. Its most common causes are Graves' disease and functioning thyroid adenomas. 3. Clinical manifestations include nervousness, palpitations, heat intolerance, weight loss, and bulging eyes. Diagnosis involves thyroid function tests showing decreased TSH and increased T3 and T4. Treatment options are antithyroid medications, radioactive iodine, surgery, and beta blockers.

1. 1 Binita Bhattarai

2. Binita Bhattarai2

3. Binita Bhattarai3

4. 4
-Prepared By
Binita Bhattarai
Bsc Nsg 4th yr
6th batch

5. Introduction
Hyperthyroidism is the second most common endocrine
disorder.
It results from an excessive output of thyroid hormones
due to abnormal stimulation of the thyroid gland by
circulating immunoglobulins.
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6. Definition
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Hyperthyroidism is an over production of thyroid hormone
which creates far reaching metabolic effects.
A high level of thyroid hormone increases the metabolic
rate.
It enhances the activity of norepinephrine due to increase
in number of beta adrenergic receptors sites in the body.

7. Incidence
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It affects women eight times more frequently than men.
It is peak between second and fourth decades of life.

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9. Causes
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Most common causes Rarer causes
Graves disease Abnormal secretion of TSH
Functioning adenoma Thyroiditis
Toxic multinodular Goiter Excessive iodine intake
Excessive intake of thyroid
hormone
Certain medications like
amiodarone

10. Grave’s disease
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14. Pathophysiology
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 Hyperthyroidism results from an excessive amount
of circulating thyroid hormone.
 Primary hyperthyroidism occurs when a problem is
within thyroid gland.
 Secondary hyperthyroidism occurs when a
problem is in other than thyroid gland.(pituitary
and hypothalamus).

15. Clinical manifestation
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Nervousness,irritability,inability to sit quietly,palpitation
Rapid pulse on rest and exertion.
Poor intolerence of heat;excessive perspiration;skin that
is flushed with a characteristic salmon color and
likely to be warm,soft and moist.

16. Contd..
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 Dry skin and diffuse pruritus.
 Fine tremors of the hands.
 Exophthalmos(bulging eyes).
 Increased appetite and dietary intake

17. Contd..
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Progressive weight loss
Abnormal muscle fatigability,
 Weakness,
Amenorrhea ,changes in bowel pattern.
Blood pressure elevation,

18. Contd..
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 Cardiac effects may include sinus tachycardia , increased
pulse pressure and palpitation,myocardial hypertrophy and
heart failure may occur if hyperthyroidism is severe and
untreated.
 Osteoporosis and fracture,

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Sinus
tachycardia
Myocardial
hypertrophy

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21. Diagnostic
Evaluation
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22. Medical Management
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Drug therapy
a) Antithyroid drug(propylthiouracil) and Methimazole
(Tapazole):block synthesis of thyroid hormone
b) Adrenergic blocking agents(commonly propranolol)
Radioactive iodine
 It is given to destroy the overactive thyroid cells.
 It is most commonly used in elderly patients.
 It is contraindicated in pregnancy and lactating mothers.

23. Contd…
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Adjunctive therapy
• Potassium iodide,Lugol’s solution and saturated
solution of potassium iodide (SSKI)may be added.
• Beta-adrenergic agents may be used to control the
sympathetic nervous system effects that occurs in
hyperthyroidism.
• For eg:propanolol is used in
nervousness,tachycardia,tremor,anxiety and heat
intolerance.

24. Surgical intervention
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 Before surgery , propylthiouracil is given for until signs of
hyperthyroidism disappeared.
 Thyroidectomy is performed after thyroid function has
returned to normal (4 to 6 weeks)

25. Nursing Intervention
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Maintaining normal body temperature
• Provide a cool, comfortable environment and fresh
bedding and gown as needed.
• Give cool baths and provide cool fruits; monitor body
temperature.

26. Contd..
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Improving Nutritional Status
• Provide several small and well balanced meals (up to 6
times) to satisfy patient’s increased appetite.
• Replaced food and fluids lost through diarrhea and
diaphoresis and control diarrhea that results from increased
peristalsis.
• Reduce diarrhea by avoiding highly seasoned foods and
stimulate such as coffee ,tea, cola and alcohol; encourage
high calorie, high protein food.
• Provide quiet environment during meal time to aid digestion.

27. Contd…
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Enhanching coping measures
• Reassure the patient that the emotional reactions being
experienced are a result of the disorder and that with
effective treatment those symptoms will be controlled.
• Reassure family and friends that symptoms are
expected to disappear with treatment .
• Maintain a calm,unhurried approach and minimize
stressful experiences.
• Provide information regarding thyroidectomy and
preparatory pharmacotherapy to alleviate anxiety.

28. Contd…
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Improving Self-Esteem
• Convey to patient an understanding of concerns
regarding problems with appearance ,appetite and weight
and assist in developing coping strategies.
• Provide eye protection if patients experience eye changes
secondary to hyperthyroidism.
• Discourage smoking.
• Arrange for patient to eat alone, if desired and if
embarrassed by the large meals consumed due to
increased metabolic rate.
• Avoid commenting on intake.

29. MCQs
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Exophthalmos refers to:
 Redness of eyes
 Bulging of eyes
 Edema of hands
 Swelling of feet
Major cause of hyperthyroidism is:
 Thyroiditis
 Excessive iodine
 Grave’s diseases
 Amiodarone

30. Answers
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Exophthalmos refers to:
 Redness of eyes
 Bulging of eyes
 Edema of hands
 Swelling of feet
Major cause of hyperthyroidism is:
 Thyroiditis
 Excessive iodine
 Grave’s diseases
 Amiodarone

31. Assigenment
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Write the prevention of
hyperthyroidism?

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