Sandra Vanessa V.

Jusi
SN-BC

Thyroid dysfunction - can range from a small, harmless goiter (enlarged gland)
that needs no treatment to life-threatening cancer. The most
common thyroid problems involve abnormal production of thyroid hormones. Too
much thyroid hormone results in a condition known as hyperthyroidism.

Hyperthyroidism - Hyperthyroidism is a hyperthyroid state resulting from

hypersecretion of thyroid hormones (T3 and T4).

1. Hyperthyroidism is characterized by an increased rate of body metabolism.

2. A common cause is Graves’ disease, also known as toxic diffuse goiter.
3. Clinical manifestations are referred to as thyrotoxicosis.

Assessment

1. Enlarged thyroid gland (goiter)

4. Palpatations, cardiac dysrhythmias, such as tachycardia or atrial fibrillation
5. Protruding eyeballs (exophthalmos) possibly present
6. Hypertension
7. Heat intolerance
8. Diaphoresis
9. Weight loss
10. Diarrhea
11. Smooth, soft skin and hair
12. Nervousness and fine tremors of hands
13. Personality changes
14. Irritability and agitation
15. Mood swings
16. Oligomenorrhea (Irregular menstrual periods in women)

Primary Nursing Diagnosis

▪ Activity intolerance related to exhaustion and fatigue

Nursing Interventions

1. Provide adequate rest.

17. Administer sedatives as prescribed.
18. Provide a cool and quiet environment.
19. Obtain weight daily.
20. Provide a high-calorie diet.
21. Avoid the administration of stimulants.
22. Administer antithyroid medications (propylthiouracil [PTU]) that block thyroid
synthesis, as prescribed.
23. Administer iodine preparations that inhibit the release of thyroid hormone as
prescribed.
24. Administer propranolol (INderal) for tachycardia as prescribed.
 25. Prepare the client for radioactive iodine therapy, as prescribed, to destroy
thyroid cells.
26. Prepare the client for thyroidectomy if prescribed.

Hypothyroidism - Hypothyroidism is a hypothyroid state resulting from a

hyposecretion of the thyroid hormones T4 and T3. Hypothyroidism is characterized
by decreased rate of body metabolism.

Risk Factors

▪ Age over 50 years

▪ Being female

Assessment

1. Lethargy and fatigue

27. Weakness, muscle aches, paresthesias
28. Intolerance to cold
29. Weight gain
30. Dry skin and hair
31. Loss of body hair
32. Bradycardia
33. Constipation
34. Generalized puffiness and edema around the eyes and face.
35. Forgetfulness and loss of memory
36. Menstrual disturbances
37. Cardiac enlargement, tendency to develop congestive heart failure.

Primary Nursing Diagnosis

▪ Activity intolerance related to weakness and apathy

Nursing Interventions

1. Monitor vital signs, including heart rate and rhythm.

38. Administer thyroid replacement, levothyroxine sodium (Synthroid) is most
commonly prescribed.
39. Instruct the client about thyroid replacement therapy.
40. Instruct the client in low-calorie, low-cholesterol, low-saturated-fate diet.
41. Assess the client for constipation; provide roughage and fluids to prevent
constipation.
42. Provide a warm environment for the client.
43. Avoid sedatives and narcotics because of increase sensitivity to these
medications.
44. Monitor for overdose of thyroid medications, characterized by tachycardia,
restlessness,, nervousness, and insomnia.
45. Instruct the client to report episodes of chest pain immediately.