Risk Factors Causes Causes

> Gender >Grave’s Disease > Overactive Pituitary Gland

Hyperthyroidism (overactive > Age >Toxic Thyroid Nodule (Adenoma) >Papillary Thyroid Carcinoma
thyroid) - occurs when your > Lifestyle > Subacute Thyroiditis > Excessive intake of Thyroid Hormone
thyroid gland produces too > Autoimmune Disorders > Excessive Iodine intake
much of the hormone > Recent Pregnancy
thyroxine. It can accelerate your > Family history of thyroid disease or
body’s metabolism, causing auto immune disease
unintentional weight loss and > Personal history of thyroid problems,
rapid irregular heartbeat. like goiter or having bad thyroid surgery
> Consuming significant amounts of
iodine through food or medication Glucocorticoids
(Class of Corticosteroids w/c are a class of steroid
hormones)
Fine Needle Biopsy
Fights inflammation and work with your immune
system

Thyroid-Stimulating Hormone
Palpation and Auscultation of the
Acropachy Thyroid Gland
Pretibial Myxedema

? Inflammation in the thyroid gland Subtotal Thyroidectomy

Total Thyroidectomy
Opthalmopathy
Thyroid Scan Enlargement of the thyroid gland (Goiter)
Radioactive Iodine Uptake
Exophthalmos

PBI (protein bound iodine)

Radiation Therapy
Hyperactivity of the Thyroid Gland Levothyroxine and Thyroglobulin
Vision loss or Diplopia
KISS or Lugol’s Solution (Calcium-Channel Blocker) (Thyroid Hormones)
(Potassium Iodine Saturated Solution) Smooth muscle Dilators and Puts the thyroid Gland at rest. These are slow acting
To inhibit release of thyroid hormone have negative inotropic effect drugs and usually take about 10 days to take effect

Increase release of the Thyroid

Risk for injury
Hormone
T3 and T4 levels

Basal Metabolic Rate

Increase Calcitonin production Increase Triiodothyronine (T3) production Palpitations Arrythmia Increase Thyroxine (T4) production

Hypertension Heart Failure

High calcium absorption to the bones High Metabolic Rate High Basal Temperature

Hypocalcemia Weight loss Imbalanced Nutrition (less than Heat Intolerance

Increased appetite
body requirements) related to
hypermetabolic state
Blurry Vision Diaphoresis
Urinary Retention Hyperactivity of Sympathetic
Constipation Nervous System Disturbance in self-esteem related
Imbalanced body temperature
Orthostatic hypotension to changes in appearance, excessive
Photosensitivity appetite, and weight loss
Drymouth
Increase Neuromuscular Activity

Irritability
Excess contraction of Fine tremors
Restlessness
Muller Muscle Shake Handwriting Thionamides
Nervousness
Clumsiness (Antithyroid Hormone)
Act principally by blocking the synthesis of T4 by
Propranolol preventing iodination of thyroxine residues
Lid Lag (B-Adrenergic Blocking Agent)
Ineffective coping related to Lid Retraction Muscle wasting Abolishes tachycardia, tremor, excess
hyperactivity of SNS Muscle Atrophy sweating and nervousness
Muscle Paralysis

Decreased Cardiac Output related to

increased cardiac work

Tachycardia

Risk for Fluid Volume Deficit

Vomiting
Diarrhea

Impaired gas exchange related to

Thyrotoxicosis (Thyroid Storm)
Ineffective Tissue Perfusion excess fluid in the lungs
Pulmonary Edema

Cardiogenic Shock Coma

Hypertension
Nause
High Fever
Impaired Skin Integrity related to Shock
Immobility Tremors
Death Emotional Lability
Extreme Irritability
Confusion
Delirium
Psychosis
Apathy
Stupor
Abdominal Pain
Jaundice
 Risk for injury
>Educate the patient on how to use the braille call light when
asking for assistance
> Keep the patient’s room clutter free at all times
> Keep away any hazardous, skidding, or sharp objects from
the room
> Educate and describe to the patient the room layout
> The nurse will assess the patients concerns about safety in
the room
Ineffective coping related to hyperactivity of SNS
>Maintain a calm, unhurried approach and minimize
stressful experience
> Encourage relaxing activities that will not overstimulate
the client
> Reassure family and friends that symptoms are expected
to disappear with treatment
Impaired gas exchange related to excess fluid in the lungs
>Assess the client’s respiratory rate, rhythm, and depth
> Assess client’s heart rate and blood pressure
> Assess for any signs of changes in the level of
consciousness
> Auscultate the lung for areas of decreased ventilation and
the presence of adventitious sounds
> Assess for cyanosis or pallor by examining the skin, nail
beds, and mucous membranes
> Monitor oxygen saturation using pulse oximetry
> Monitor arterial blood gasses
> Assist the client when coughing, and suction the client
when needed
> Place the client’s head of bed elevated
>Administer oxygen as ordered
> Prepare the client for mechanical ventilation if oxygen
therapy is ineffective
Imbalanced Nutrition (less than body requirements)
related to hypermetabolic state
>Provide client with a well-balanced, high calorie diet
> Six full meals a day may be needed to satisfy their
appetite
> Encourage the client to eat foods that are nutritious and
contain ample amounts of protein, carbohydrates, fats, and
minerals
> Discourage the ingestion of foods that increase peristalsis
and thus result in diarrhea, such as high seasoned, bulky, or
fibrous foods.
> The client should be weighed daily, and weight losses of
more than 2kg should be reported
Risk for Impaired Skin Integrity related to Immobility
>Determine nutritional status and potential for delayed
healing and tissue injury exacerbated by malnutrition
> Evaluate client with impaired cognition, developmental
delay, need for or use of restraints, long term immobility
> Note skin color, texture, and turgor. Assess areas of least
pigmentation for color changes
> Inspect surrounding skin for erythema, induration,
maceration
>Perform turning of the client every 2 hours
Ineffective Tissue Perfusion
>Assess the client’s HR, BP, and pulse pressure. Use direct
intra-arterial monitoring as directed
> Assess for any changes in the level of consciousness
> Assess capillary refill
> Monitor oxygen saturation and arterial blood gasses
> Restrict the patient’s activity, and maintain the client on
bed rest
> Provide oxygen therapy as indicated
> Administer IV fluids as ordered
Disturbance in self-esteem related to changes in Imbalanced body temperature
appearance, excessive appetite, and weight loss >Tell the client to stay in a cool environment
>Provide an atmosphere of acceptance > Use only a lightweight sheet for the top cover, and
> Appraise the client’s adjustment to body image give the client light, loose pajamas.
> Explore with her previous methods of dealing life problems > The client who is diaphoretic may need fresh bed
> Encourage verbalization of feelings, perceptions, and fears. sheets and clothes frequently
> Encourage the client to identify her own strengths and > Encourage the client not to overexert because doing
abilities so raises the body temperature and metabolic rate
> Foster constructive outlets for anger and hostility
>Determine barriers to using support systems
> Discuss with concerned others how they can help
Risk for Fluid Volume Deficit
>Monitor and document vital signs especially BP and HR
> Assess skin turgor and oral mucous membranes for
signs of dehydration
> Assess color and amount of urine. Report urine output
less than 30 mL/hr for 2 consecutive hours
>Monitor and document temperature
> Monitor client’s mental status every 2 hours
Decreased Cardiac Output related to increased cardiac > Encourage to increase fluid intake at least 2-3 L per
work day
>Assess for any changes in the level of consciousness > Auscultate and document heart sounds; note rate,
> Assess the client’s HR, BP, and pulse pressure. Use direct rhythm or other abnormal findings
intra-arterial monitoring as directed > Monitor serum electrolytes and urine osmolality, and
> Assess the cardiac rate, rhythm, and electrocardiogram report abnormal values
(ECG)
> Assess the central and peripheral pulses
> Assess capillary refill
> Assess respiratory rate, rhythm, and auscultate breath
sounds
> Monitor oxygen saturation and arterial blood gasses
> Monitor the client’s central venous pressure (CVP),
pulmonary artery diastolic pressure (PADP), pulmonary
capillary wedge pressure, and cardiac output/cardiac index
> Assess fluid balance and weight gain
> Assess urine output
> Administer IV fluids for clients with a decreased preload
> Administer oxygen as prescribed
> Administer medications as prescribed