Wednesday, September 7, 2016

MED SURG~Hyperthyroidism

Hyperthyroidism 


What is it: Hyperactive thyroid gland. It is an excessive amount of thyroid hormones circulating.

Pathophysiology: Graves disease causes excessive thyroid hormone production. The body develops antibodies to the TSH receptor. They attach to the receptors and cause an excessive release of T3 and T4. 

What makes it worse: Smoking and iodine 

What Normally Happens in the body: The thyroid gland secretes T3 and T4 hormones. Iodine synthesises these hormones. The release of thyroid hormones generation and release is triggered by TSH by the anterior pituitary gland. 

Possible Causes: Graves Disease

Signs and Symptoms: Increased hr, bounding pulse, palpations, angina, increased respirations, dyspnea on exertion, increased appetite and thirst, diarrhea, increased bowel sounds, thin nails, hair loss, clubbing, fine hair, premature gray in men, diaphoretic, vitiligo, hyperthermia, restless, delirium, coma, shock, and seizures. 

Lab and Diagnostics: Increased T3 and T4 levels and RAIU test 

Medications: Antithyroid drugs and Beta Adrenergic blockers

Nursing Interventions: Auscultate the thyroid gland for bruits, palpate for a goiter, abnormal eye appearance/exophthalmos, dry corneas present, is there any diplopia, look for thyrotoxicity, get rest, eye care related to dryness, pre-op and post-op care for thyroidectomy. 

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