HYPERTHYROIDISM

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HYPERTHYROIDISM
Hyperthyroidism is a clinical condition resulting from over production of thyroid hormones.

 CAUSE; The cause is unknown. However, the excessive secretion of thyroid hormones is thought to occur following abnormal stimulation of the thyroid gland by circulating immunoglobulin called LATS (long-acting thyroid stimulator).

Predisposing Factors
1. Emotional shock
2. Stress
3. Infection-thyroiditis
4. Over treatment of hypothyroidism and administration of iodides
5. Radiation injury following by released of stored thyroid hormones

PATHOPHYSIOLOGY
Hyperthyroidism is a clinical condition resulting from excessive thyroid hormone production or secretion in the blood. These over secretion of thyroid hormones result in hyperplasia and cellular growth and proliferation evident by enlargement of the thyroid gland.With increase in thyroid hormone, the metabolic rate is elevated. There are increased or accelerated protein, fat and carbohydrate metabolism. Which leads to weight loss, muscular weakness, loss of appetite, palpitations, insomnia, elevated systolic blood pressure.

Clinical Manifestation
1. Thyroid gland enlargement
2. Warm moist skin
3. Increased in sweating
4. Weight loss
5. Diarrhoea
6. Restlessness
7. Insomnia
8. Exophthalmos
9. Tremors
10. Nervousness

DIAGNOSTIC EVALUATION
1. Measurement of elevation of serum levels of thyroxin and triiodothyronine.
2. Radioactive reuptake
3. Protein bound iodine

COMPLICATION
1. Heart failure
2. Heat imbalance
3. Exophthamos
4. Thyroid storm
5. Thyroid psychosis


MEDICAL MANAGEMENT
pharmacology: drug use are anti-thyroid drugs e.g propylthuracil and methimazole irradiation (radioactive iodide therapy); this is to destroy the over active thyroid cells surgery; the best form of surgery is subtotal thyroidectomy

NURSING MANAGEMENT
Ø Admission of patient into noise free environment since noise will aggravate symptoms
Ø Position patient in a comfortable way for adequate bed rest
Ø Observation of vital signs should be highly considered since vital organs are affected
Ø DIET; proper oral hygiene should be carried out to stimulate appetite.
Ø Drugs are given as prescribed and side effects are been watched
Ø Physical care: attention should be given to pressure areas it paying has lost weight ensure cool and comfortable environment
Ø Health educate the patient family on the disease condition and its care.

NURSING DIAGNOSIS
1. Imbalance nutrition less than body requirement, related to increased metabolic rate evidenced by weight loss
2. Low self-esteem related to changes in appearance and weight loss evidenced by withdrawal from the public

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