Hyperthyroid
Hyperthyroid
Hyperthyroid
>TOXIC GOITER
Thyroid Gland
Thyroid Hormone
a. T4 - Thyroxine – body heat production
b. T3 – Triiodothyronine – Metabolism & growth
c. Calcitonin – Thyrocalcitonin – decrease level of
calcium in blood.
Hyperthyroidism “Grave’s Disease”
>Toxic Diffuse Goiter/ Parry’s Disorder
Risk Factors:
•Females, Below 40yrs old
•Severe Emotional Stress
•Autoimmune Disorders
PREDISPOSING:
PATHOPHYSIOLOGY PRECIPITATING:
stress
GENDER HYPERTHYROIDISM
pregnancy
AUTOIMMUNE
Increase in T3 and T4
Hormonal Imbalance
Multi-system Changes
Physical Neuro-
CV Nutrition Musculo- Psycho- Integu-
logical
skeletal logical mentary
System
Enlarge HR
Weight
Thyroid Irritability
BP Loss Anxiety Sweating
gland Restless
Appetite Insomnia Heat
Fine Intolerance
Respira-
Eyes Tremors
tory
System
Exopthalmos
RR
Assessment:
>Thyroidal Disturbances
*Restlessness, nervousness, irritability, agitation
*Fine tremors
*Tachycardia
*HPN
*increase appetite
*Weight loss
*Diaphoresis
*Diarrhea
*Heat intolerance
*Amenorrhea
*Fine silky skin
*Pliable nails
>Ophthalmopathy
*Exophthalmos
*Accumulation of Fluids at the fat pads behind eyeballs,
pushing the eyes forward
Graves’
Ophthalmpathy
Preparation:
*NPO 10-12hrs
7. Reflex Testing
>Hyperactive Tendon of Achilles Reflex (TAR) indicate
Hyperthyroidism
Treatment:
A. General management
Sedatives for restlessness/insomnia
B. Management
A. Medical
1. Propylthiouracil (PTU), Methimazole (MM)
> Inhibits synthesis of thyroid hormones
Side effects:
*agranulocytosis, fever, sore throat, skin rashes
4. Beta – Blockers
>To control tachycardia, HPN
B. Radiation Therapy (131I)
a. More commonly used than before
b. Contraindications
*pregnant
*young people (<20yrs)
*severe exophthalmos
*thyrotoxic crisis
*failed to uptake I
D. Thyroidectomy
> a surgical procedure done to removed thyroid gland
when there is malignancy.
Pre-operative care:
>Promote Euthyroid state.
>Administer Iodides as ordered.
*To reduce the size & vascularity of thyroid gland, thereby to
prevent postop hemorrhage.
>ECG
*Heart failure/ cardiac damage results from HPN/ tachycardia.
Group 3
BSN 3D