Presentation on

“HYPERTHYROIDISM”
BY-

RITIKA VERMA
B.Sc NURSING, 3RD YEAR
SIHER COLLEGE OF NURSING, BAGHPAT
CONTENTS
 Introduction
 Definition
 Etiology
 Pathophysiology
 Clinical Features
 Diagnosis of Hyperthyroidism
 Management of Hyperthyroidism
 Nursing Assessment
 Nursing Management of Hyperthyroidism
 Conclusion
 Summary
 INTRODUCTION
 HYPERTHYROIDISM refers to overactivity of the
thyroid gland, which leads to the excessive release of
thyroid hormones and consequently accelerated
metabolism in the peripheral tissues.
 HYPERTHYROIDISM is a relatively rare condition in
children.
 The vast majority of cases are caused by GRAVES disease.
Numerous therapeutic options are available, so most
patients do well.
DEFINITION

 According to “WATSON’s” – Hyperthyroidism is hyperactivity of the

thyroid gland with sustain increase in synthesis and release of
hormones.

or

 Hyperthyroidism is characterized by excessive levels of circulating

thyroid hormones.
The following image depicts the HYPOTHALAMIC-PITUITARY-THYROID
Negative/Positive Feedback system.
ETIOLOGY
HYPERTHYROIDISM (thyroid causes of Thyrotoxicosis) in childhood include
the following:
 Graves disease
 Toxic adenoma, toxic nodular goiter
 McCune-Albright syndrome
 Subacute (viral thyroiditis)
 Chronic lymphocytic thyroiditis (.e., Hashitoxicosis in its early stage)
 Bacterial thyroiditis
 Ingestion of thyroid hormone
 Ingestion of food containing thyroid hormone
 Genetic factor
 High dietary IODINE intake or very low dietary intake.
 Pituitary disease [Pituitary resistance to T4, Human chorionic
gonadotropin (hCG)-secreting tumors]
 PATHOPHYSIOLOGY
 Hyperthyroidism characterized by loss normal regulatory control
of thyroid hormone secretion.
 The action of thyroid hormone on the body is stimulatory, hyper
metabolism result.
 Increase sympathetic nervous system activity.
 Alteration secretion and metabolism of hypothalamic pituitary and
gonadal hormone.
 Excessive amount of thyroid hormone stimulate the cardiac system snd
increase the adrenergic receptors.
 Tachycardia and increase cardiac output, stroke volume and peripheral
blood flow.
 Negative nitrogenous balance, lipid depletion and the resultant state of
nutritional deficiency.
CLINICAL FEATURES of HYPERTHYROIDISM
 Goiter
 Increased rate of growth
 Weight loss
 Increased appetite
 Warm, moist skin
 Tachycardia, & Palpitations
 Emotional liability
 Insomnia
 Motor hyperactivity & excitability
 Opthalamic changes like- [ Exophthalmos (bulging of eyeballs), Ptosis
(drooping of eyelid), Proptosis (downward displacement of eyeball),
Starring expression, Periorbital edema, Diplopia ]
THYROID CRISIS:
 It is characterized by sudden onset, high temperature, tachycardia,
and restlessness with rapid progression to delirium, coma and death.

 Nervousness and irritability

 Lower leg swelling

 Impaired fertility

 Decreased menstrual flow

DIAGNOSIS of HYPERTHROIDISM

 History collection
 Physical examination
 ECG –Atrial tachycardia
 High radioactive – iodine uptake
 Thyroid function test : T4 and T3
 Thyroid stimulating hormone (TSH) stimulation Test
 Radionuclide scanning of thyroid gland
MANAGEMENT of HYPERTHYROIDISM

A. Medical Management
Radioactive Treatment
B. Surgical Management
NURSING ASSESSMENT of
HYPERTHYROIDISM

 Vital signs
 Lung sounds
 Anxiety level
 Weight
 Bowel function
 Never palpate Goitre
Initiate Release TH
NURSING MANAGEMENT OF
HYPERTHYROIDISM

1. IMBALANCED NUTRITION less then body requirement

related to anorexia and increase metabolic demand is inappropriate.

Intervention –
o High calorie diet (4000-5000 kCal/day)
o High protein diet (1-2g/kg of ideal weight)
o Frequent meals

2. ACTIVITY INTOLERANCE related to exhaustion secondary to

accelerated metabolic rate resulting in inability to perform activity without
shortness of breath and significant increased in heart rate.

INTERVENTION –
o Assist with regular physical activity
o Assist the patient to schedule rest periods
o Assist in activities of daily living
3. RISK for INJURY : Corneal ulceration, Infection and not
possible blindness related inability to close the eye lids secondary to
exophthalmos.

4. IMPAIRED SOCIAL INTERACTION related to extreme

Agitation, Hyperactivity, & Mood swings resulting in inability to relate
effectively with others.
CONCLUSION

 HYPERTHYROIDISM is potentially a fatal disease.

 Serum test is the best screening test.
 Serum T4, Serum T3 and Radioactive iodine tests will be elevated.
 With proper treatment patients will do well and live a normal life.
SUMMARY

 Excess thyroid hormone increases metabolism & can cause weight loss,
sweating and a rapid heart beat.
 It can also affect child’s mood, making them nervous, irritable and
anxious
 Hyperthyroidism affects many cells and tissues throughout the body,
including the brain, heart, bone, skin, and intestinal tract.
…Thank
you…