2. Objectives:
• Define hyperthyroidism.
• Define goiter and discus its types.
• Discus the causes of hyperthyroidism.
• Describe the sign and symptoms, complication of
hyperthyroidism.
• How to diagnose the hyperthyroidism.
• Explain the treatment and nursing care of
hyperthyroidism.
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3. Definition:
Hyperthyroidism is a disorder in which
your thyroid gland makes and releases more
thyroid hormone than your body needs.
OR
Hyperthyroidism (overactive thyroid) is a
condition in which your thyroid gland
produces too much of the hormone thyroxine.
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7. What is goiter:
• Goiter is a swelling of the neck resulting from
enlargement of the thyroid.
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8. Types of the goiter:
• Simple goiter:
A simple goiter is an enlargement of the thyroid
gland. It is usually not cancer.
• Toxic goiter:
Toxic multinodular goiter: A condition in which the
thyroid gland contains multiple lumps (nodules) that
are overactive and that produce excess thyroid
hormones.
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10. Causes of Hyperthyroidism:
• Functioning adenoma ("hot nodule") and toxic
multinodular goiter (TMNG)
• Excessive intake of thyroid hormones drugs.
• Abnormal secretion of TSH.
• Hypertrophy, Hyperplasia of thyroid gland.
• Graves' Disease.
• Thyroiditis (inflammation of the thyroid gland)
• Excess iodine (iodine is needed to make T4 and T3)
• Benign tumors of the thyroid or pituitary gland.
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12. Complications of Hyperthyroidism: -
• Heart problems. Some of the most serious
complications of hyperthyroidism involve the heart.
These include a rapid heart rate, a heart rhythm disorder
called atrial fibrillation and congestive heart failure.
• Brittle bones. Untreated hyperthyroidism can also lead
to weak, brittle bones (osteoporosis).
• Eye problems. People with Graves' ophthalmopathy
develop eye problems, including bulging, red or
swollen eyes, sensitivity to light, and blurring or
double vision.
• Others. Weight loss, Hand tremors, Corneal ulcer.
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13. Diagnostic Investigation: -
• The first step is a complete history and physical
examination.
• CBC
• TSH
• T3, T4
• Calcium
• Thyroid scan
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14. Treatment of Hyperthyroidism: -
• Anti-thyroid medications. These medications
gradually reduce symptoms of hyperthyroidism by
preventing your thyroid gland from producing excess
amounts of hormones eg:Tab: Neumercazole 5mg.
• Surgery to remove all or part of the thyroid, called a
thyroidectomy.
Most people who have this procedure eventually
develop an underactive thyroid and will need to take
thyroid hormone-replacement medication for the rest
of their life.
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15. Treatment of Hyperthyroidism: -
• Beta-blockers to slow down your heart rate. These
medicines do not lower your thyroid hormone levels
but help relieve symptoms related to a rapid heart rate.
• Ask your doctor about supplementing your diet. If
you've lost a great deal of weight or experienced
muscle wasting, you may benefit from adding extra
calories and protein to your diet.
• Get enough calcium and vitamin D. Because
hyperthyroidism may contribute to thinning bones, it's
important to get enough calcium every day to help
prevent osteoporosis.
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16. Treatment of Hyperthyroidism: -
• Get regular exercise. Exercise in general will help
you feel better and improve your muscle tone and
cardiovascular system.
• Wear sunglasses. When your eyes protrude, they're
more vulnerable to ultraviolet rays and more sensitive
to sunlight.
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17. Nursing Intervention: -
• Administer prescribed antithyroid medications, as ordered.
• If iodine is part of the treatment, mix it with milk, juice, or
water to prevent gastrointestinal distress, and give it through a
straw to prevent tooth discoloration.
• Give antidiarrheal preparations as ordered.
• Consult a dietician to ensure a nutritious diet with adequate
calories and fluids.
• Minimize physical and emotional distress.
• Monitor and record patient’s vital signs, weight, fluid intake,
and urine output.
• Evaluate serum electrolyte levels, and check for hyperglycemia
and glycosuria.
• Assess the patient for signs of heart failure.
• Reassure the patient and his family that mood swings and
nervousness will probably subside with treatment
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