Case Study of Hyperthyroidism

Good Samaritan Colleges
Burgos Ave., Cabanatuan City, Nueva

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Case Study
of
Hyperthyroidism
Prepared by:
BSN 3 – GROUP A
Adriano, Lee Airish DG.
Angeles, Ghines Ayessha S.
Angulo, Kyla DG.
Bagayas, Divine Grace S.
Balcorta, Rosemarie D.
Baldueza, Forteliza C.
Balmores, Monneth G.
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I. INTRODUCTION
Hyperthyroidism is a pathological disorder in which excess
thyroid hormone is synthesized and secreted by the thyroid
gland. It is characterized by normal or high thyroid
radioactive iodine uptake (thyrotoxicosis with
hyperthyroidism or true hyperthyroidism). Thyrotoxicosis
without hyperthyroidism is caused by extrathyroidal sources
of thyroid hormone or by a release of preformed thyroid
hormones into the circulation with a low thyroid radioactive
iodine uptake.
Hyperthyroidism, also called overactive thyroid, is a

condition where your thyroid makes and releases high levels
of thyroid hormone. This condition can make your metabolism
speed up. Symptoms of hyperthyroidism include a rapid
heartbeat, weight loss, increased appetite and anxiety.
Hyperthyroidism can be treated with antithyroid drugs,
radioactive iodine, beta blockers and surgery.
II. DEFINITION
Hyperthyroidism is the abnormal function of your thyroid
gland, an organ located in the front of your neck that
releases hormones to regulate your body’s use of energy. In
other words, if you have high thyroid levels, it means that
your thyroid gland is overactive and makes more thyroid
hormones than your body needs, which causes hyperthyroidism.
The hormones produced by your thyroid gland are thyroxine

(T4) and triodothyronine (T3) and they play an important role
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in the way your entire body functions. For this reason, when
there is an imbalance, such as high T4, it can have far-
reaching effects on almost every aspect of your health.
Thyroid Hormones Control your:
 metabolism
 breathing
 heart rate
 nervous system
 weight
 body temperature
III. REVIEW OF ANATOMY AND PHYSIOLOGY

Anatomy and Physiology of the Thyroid Gland
A butterfly-shaped organ, the thyroid gland is located
anterior to the trachea, just inferior to the larynx. The
medial region, called the isthmus, is flanked by wing-shaped
left and right lobes. Each of the thyroid lobes are embedded
with parathyroid glands, primarily on their posterior
surfaces. The tissue of the thyroid gland is composed mostly
of thyroid follicles. The follicles are made up of a central
cavity filled with a sticky fluid called colloid. Surrounded
by a wall of epithelial follicle cells, the colloid is the
center of thyroid hormone production, and that production is
dependent on the hormones’ essential and unique component:
iodine.
The thyroid gland is located in the neck where it wraps

around the trachea. (a) Anterior view of the thyroid gland.
(b) Posterior view of the thyroid gland. (c) The glandular
tissue is composed primarily of thyroid follicles. The
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larger parafollicular cells often appear within the matrix

of follicle cells.
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IV. PATHOPHYSIOLOGY
In hyperthyroidism, serum T3 usually increases more than
does T4, probably because of increased secretion of T3 as
well as conversion of T4 to T3 in peripheral tissues. In
some patients, only T3 is elevated (T3 toxicosis).
T3 toxicosis may occur in any of the usual disorders that

cause hyperthyroidism, including Graves’ disease,
multinodular goiter, and the autonomously functioning
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solitary thyroid nodule. If T3 toxicosis is untreated, the

patient usually also develops laboratory abnormalities
typical of hyperthyroidism (ie, elevated T4 and iodine-123
uptake). The various forms of thyroiditis commonly have a
hyperthyroid phase followed by a hypothyroid phase.
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V. SIGNS AND SYMPTOMS

 Symptoms of an overactive thyroid can include:
 nervousness, anxiety and irritability
 hyperactivity – you may find it hard to stay still
and have a lot of nervous energy
 mood swings
 difficulty sleeping
 feeling tired all the time
 sensitivity to heat
 muscle weakness
 diarrhea
 needing to pee more often than usual
 persistent thirst
 itchiness
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 loss of interest in sex
 An overactive thyroid can also cause the following

physical signs:
 a swelling in your neck caused by an enlarged thyroid
gland (goitre)
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 an irregular and/or unusually fast heart rate

(palpitations)
 twitching or trembling
 warm skin and excessive sweating
 red palms of your hands
 loose nails
 a raised, itchy rash – known as hives (urticaria)
 patchy hair loss or thinning
 weight loss – often despite an increased appetite
 eye problems, such as redness, dryness or vision
problems (see complications of an overactive thyroid
VI. DRUG STUDY
Thionamides are commonly used to treat an overactive

thyroid. They stop your thyroid producing excess hormones.
DRUG USES SIDE EFFECTS
 Carbimazole A pro-drug as after  feeling sick

absorption it is (nausea)
converted to
the  being sick
active form. It stop (vomiting) or
thyroid gland for diarrhoea
making toomuch  feeling dizzy
thyroid hormones.
 headache
 painful joints
 itchy skin or
rash
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 thinning hair
 Propylthiouracil It works by making  hair loss

it harder for the  difficulty
body to use iodine tasting food
to make thyroid  numbness,
hormone. It does not burning, or
block the effects of tingling of
thyroid hormone that the hands or
was made by the body feet
before its use was  joint or
begun. muscle pain
 dizziness
 swelling of
the neck
 Methimazole Used to treat  skin rash
hyperthyroidism, a  itching
condition where the  abnormal hair
thyroid gland loss
produces too much  upset stomach
thyroid hormone. It  vomiting
is also used before
 loss of taste
thyroid surgery or
 abnormal
radioactive iodine
sensations
treatment.
(tingling,
Methimazole is an
prickling,
antithyroid
burning,
medicine. It works
tightness, and
by making it harder
pulling)
for the body to make
 swelling
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thyroid hormone.
Once your thyroid hormone levels are under control, your

dose may be gradually reduced and then stopped. But some
people need to continue taking medicine for several years or
possibly for life.
VII. MEDICAL/SURGICAL MANAGEMENT

Several treatments for hyperthyroidism exist. The best
approach for you depends on your age, physical condition,
the underlying cause of the hyperthyroidism, personal
preference and the severity of your disorder. Possible
treatments include:
 Radioactive iodine. Taken by mouth, radioactive iodine

is absorbed by your thyroid gland, where it causes the
gland to shrink. Symptoms usually subside within several
months. Excess radioactive iodine disappears from the
body in weeks to months.
This treatment may cause thyroid activity to slow enough

to be considered underactive (hypothyroidism), and you
may eventually need to take medication every day to
replace thyroxine.
 Anti-thyroid medications. These medications gradually

reduce symptoms of hyperthyroidism by preventing your
thyroid gland from producing excess amounts of hormones.
They include methimazole (Tapazole) and
propylithiouracil. Symptoms usually begin to improve
within several weeks to months, but treatment with anti-
thyroid medications typically continues at least a year
and often longer.
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For some people, this clears up the problem permanently,

but other people may experience a relapse. Both drugs
can cause serious liver damage, sometimes leading to
death. Because propylthiouracil has caused far more
cases of liver damage, it generally should be used only
when you can't tolerate methimazole.
A small number of people who are allergic to these drugs

may develop skin rashes, hives, fever or joint pain.
They also can make you more susceptible to infection.
 Beta blockers. Although these drugs are usually used to

treat high blood pressure and don't affect thyroid
levels, they can ease symptoms of hyperthyroidism, such
as a tremor, rapid heart rate and palpitations. For that
reason, your doctor may prescribe them to help you feel
better until your thyroid levels are closer to normal.
These medications generally aren't recommended for
people who have asthma, and side effects may include
fatigue and sexual dysfunction.
 Surgery (thyroidectomy). If you're pregnant or you

otherwise can't tolerate anti-thyroid drugs and don't
want to or can't have radioactive iodine therapy, you
may be a candidate for thyroid surgery, although this is
an option in only a few cases.
In a thyroidectomy, your doctor removes most of your

thyroid gland. Risks of this surgery include damage to
your vocal cords and parathyroid glands — four tiny
glands situated on the back of your thyroid gland that
help control the level of calcium in your blood.
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In addition, you'll need lifelong treatment with

levothyroxine (Levoxyl, Synthroid, others) to supply your
body with normal amounts of thyroid hormone. If your
parathyroid glands also are removed, you'll need medication
to keep your blood-calcium levels normal.
VIII. NURSING MANAGEMENT

 Provide adequate rest.
 Administer sedatives as prescribed.
 Provide a cool and quiet environment.
 Obtain weight daily.
 Provide a high-calorie diet.
 Avoid the administration of stimulants.
 Administer antithyroid medications (propylthiouracil
[PTU]) that block thyroid synthesis, as prescribed.
 Administer iodine preparations that inhibit the release
of thyroid hormone as prescribed.
 Administer propranolol (INderal) for tachycardia as
prescribed.
 Prepare the client for radioactive iodine therapy, as
prescribed, to destroy thyroid cells.
 Prepare the client for thyroidectomy if prescribed.
IX. REFERENCE
 https://www.ncbi.nlm.nih.gov/books/NBK537053/
 https://www.endocrineweb.com/conditions/hyperthyroidism
 http://pressbooks-dev.oer.hawaii.edu/anatomyandphysiology/
chapter/the-thyroid-gland/#:~:text=Hyperthyroidism%20can
%20lead%20to%20an,may%20also%20develop%20a%20goiter.
 https://www.nhs.uk/conditions/overactive-thyroid-
hyperthyroidism/symptoms/
 https://www.emedihealth.com/glands-hormones/thyroid/treat-
hyperthyroidism
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 https://www.mayoclinic.org/diseases-conditions/
hyperthyroidism/diagnosis-treatment/drc-20373665
 https://www.rnpedia.com/nursing-notes/medical-surgical-
nursing-notes/hyperthyroidism/

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Good Samaritan Colleges

Burgos Ave., Cabanatuan City, Nueva

Adriano, Lee Airish DG.

Angeles, Ghines Ayessha S.

Angulo, Kyla DG.

Bagayas, Divine Grace S.

Hyperthyroidism, also called overactive thyroid, is a

The hormones produced by your thyroid gland are thyroxine

III. REVIEW OF ANATOMY AND PHYSIOLOGY

The thyroid gland is located in the neck where it wraps

larger parafollicular cells often appear within the matrix

T3 toxicosis may occur in any of the usual disorders that

solitary thyroid nodule. If T3 toxicosis is untreated, the

V. SIGNS AND SYMPTOMS

 loss of interest in sex

 An overactive thyroid can also cause the following

 an irregular and/or unusually fast heart rate

VI. DRUG STUDY

Thionamides are commonly used to treat an overactive

DRUG USES SIDE EFFECTS

 Carbimazole A pro-drug as after  feeling sick

 Propylthiouracil It works by making  hair loss

Once your thyroid hormone levels are under control, your

VII. MEDICAL/SURGICAL MANAGEMENT

 Radioactive iodine. Taken by mouth, radioactive iodine

This treatment may cause thyroid activity to slow enough

 Anti-thyroid medications. These medications gradually

For some people, this clears up the problem permanently,

A small number of people who are allergic to these drugs

 Beta blockers. Although these drugs are usually used to

 Surgery (thyroidectomy). If you're pregnant or you

In a thyroidectomy, your doctor removes most of your

In addition, you'll need lifelong treatment with

VIII. NURSING MANAGEMENT

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