● Surgical Intervention

PRELIM TRANSES ● Immunologic Therapy

NCM 116 MEDICAL SURGICAL Nutritional - Metabolic Patterns/response to altered nutrition

NURSING DIAGNOSIS
DISTURBANCES IN INGESTION
➔ Ineffective airway Clearance (pneumonia/asthma)
➔ Disturbed Body Image (amputation) 1. Gastroesophageal reflex disease (GERD) Occurs when
➔ Risk for unstable blood glucose (diabetes) stomach acid repeatedly flows back into the tube connecting your
➔ Impaired urinary elimination (post-prostatectomy) mouth and stomach (esophagus).
➔ Self-care deficit: Dressing (cardiovascular accident)
Signs and symptoms:
➔ Heartburn
➔ Regurgitation (food comes back into your mouth from
IMPLEMENTATION OF CARE
the esophagus)
➔ The feeling of food caught in your throat
1. Independent nursing care ➔ Coughing
Physiologic Care – ➔ Chest pain
Psychosocial Care – ➔ Problem swallowing
Spiritual Care – ➔ Vomiting
➔ Sore throat and hoarseness
Physiologic Care
➔ Managing and providing care for clients with acute, Pathophysiology
chronic or life-threatening physical health condition - GERD is the reflux of stomach acid and contents into
➔ Actions that involve a patient’s physical health or the esophagus. Past the lower esophageal sphincter
well-being (LES) causing irritation and thinning of the lower
➔ The nurse takes special care to make sure that any esophagus.
physical needs are being met and that the patient is in a - Regurgitation often occurs without effort, such as when
healthy condition lying down or bending over.
Example: sleep, rest, exercise, physical activity - Frequent recurrences without treatment may lead to
erosion of the mucus membranes of the lower
Psychosocial Care esophagus.
➔ Communication between nurses and the patient and - May be related to excessive pressure being placed on
family members as well as communication among the abdomen such as in the case of obesity or
nurses pregnancy.
Example: - Certain medications such as calcium channel blockers,
● stress management sedatives, antidepressants, and antihistamines relaxes
● self-coping skills the smooth muscle of the LES, which weakens the
● relapse prevention ability of the sphincter to fully close, thus allowing food
➔ despair, anxiety, depression, social isolation, disturbed and digestive acids to enter the esophagus.
self-esteem, fear of abandonment, loss of control, and - Patients who smoke or have a hiatal hernia are at
disturbed body image increased risk of developing GERD
Spiritual Care Nursing Responsibility
➔ Helps nurses to understand patient’s senses of honor, ● Improve nutrition
values, and experience to express kind concern for their ● Relieve pain
patients, ease patients’ stress and tension, provide them ● Prevent aspiration
with spiritual well-being and serenity, and let them find ● Enforce health education
meaning and purpose amidst painful circumstances ● Relieve anxiety
Examples: ● Prevent injury
● Spending time with the people important to them
● Spending time in nature 2. HIATAL HERNIA
● Spending time in hobbies
● Following religious customs, like prayer or going to Pathophysiology
religious services - The upper part of your stomach bulges through the large
muscle separating your abdomen and chest (diaphragm)
2. Dependent Nursing Care - Weakening of the surrounding tissue and may be
➔ Those that require guidance or supervision from a aggravated by obesity and/or smoking.
physician or other medical professionals. Triggered by the following:
➔ A part of a collaborative team of medical professionals ● Citrus foods
working together to care for a patient. ● Cranberry juice, lemonade
● Chocolate
● Pharmacological ● Fatty and fried foods
● Therapeutics ● Garlic and onions
● Complementary and Alternative Therapies ● Spicy foods
● Nutritional and Diet Therapy ● Peppermint and spearmint

Signs and symptoms:
Heartburn
- Tends to get worse in response to certain foods and
beverages, and it often occurs when a person is lying
down or bending over, especially soon after eating. It
can lead to bloating, belching, and a bad taste in the
back of the throat.
Regurgitation
- Usually asymptomatic and can only be accidentally
detected by UTZ.
Nursing Responsibilities:
● Eating- eating smaller meals to reduce stomach bulk
● Avoiding- avoiding stimulation of gastric secretions by
omitting caffeine and alcohol, which may intensify
symptoms.
● Refraining- refraining from smoking, which stimulates
gastric acid and secretions
● Avoiding - avoiding fatty foods, which promote reflex
and delay gastric emptying
Plan of Care:
● Change - change your eating habits. It’s best to eat
several small meals instead of two or three large
meals….
● Do not smoke or chew- do not smoke or chew tobacco
● Raise- If you get heartburn at night, raise the head of
your bed 6in. (15 cm) to 8in.
Overview:
Achalasia
- A rare disorder that makes it difficult for food and liquid
to pass from the swallowing tube connecting your mouth
and stomach (esophagus) into your stomach.
Signs and symptoms:
● Dysphagia- difficulty in swallowing liquids and solids
● Regurgitation- food and liquid coming back to mouth
● Chest pain- pain in the upper abdomen or chest
● Weight loss
Nursing Responsibility:
- Patient education centers on adaptations the patient
make to avoid esophageal pain, regurgitation, and
weight loss
DISTURBANCES IN DIGESTION
1. Nausea and Vomiting
- Unpleasant sensation in the throat, epigastric area,
or abdomen that may cause a conscious desire to
vomit but doesn’t always lead to vomiting.
- May occur in relation to gastrointestinal problems
What is the difference between gastritis and indigestion?
like infection, overeating, acid reflux. obstruction ,
and more.
- changes in bowel habits, stool color (to black or
red) and consistency and the presence of pain of
tenderness may tell you which area of the GI tract
is affected.
- Intake of iron, bismuth or foods like beets can give
the stool the same appearance as bleeding from
the digestive tract, a doctor must test the stool for
blood before offering a diagnosis.
Nursing Responsibilities:
- To maintain hydration status and effectively counter
fluid and electrolyte losses.
- Fluid therapy is a fundamental part of treatment.
Intravenous fluids may be administered to those
individuals who appear dehydrated or to those
unable to tolerate oral fluids.
GASTRITIS
- Gastritis is a condition that inflames the stomach
lining (the mucosa), causing belly pain, indigestion
(dyspepsia), bloating, and nausea.
- It can lead to other problems.
- Gastritis can occur suddenly (acute) or gradually
(chronic).
- Medications and dietary changes can reduce stomach
acid and ease gastritis symptoms.
- Your stomach has a protective lining of mucus called
the mucosa.
- This lining protects your stomach from the strong
stomach acid that digests food.
- When something damages or weakens this protective
lining, the mucosa becomes inflamed, causing
gastritis.
- A type of bacteria called Helicobacter pylori is the
most common bacterial cause of gastritis.
ISELPIN= take the medication on an empty stomach to hold
the mucosal lining
 SIGNS AND SYMPTOMS:
- Gastritis symptoms can mimic indigestion symptoms.
- Indigestion is pain or discomfort in the stomach ➔ Loss of appetite
associated with difficulty in digesting food. ➔ Black, Tarry stools
- It may be a feeling of burning between your lower ➔ Abdominal bloating
ribs. ➔ Abdominal pain
- You may hear indigestion referred to by its medical ➔ Hiccups
term, dyspepsia. ➔ Burning or gnawing feeling in the stomach between
meals or at night
Who might get gastritis? ➔ Indigestion
➔ Vomiting blood or coffee ground-like material
- Your risk of developing gastritis goes up with age. ➔ Nausea or recurrent upset stomach
- Older adults have thinner stomach linings, decreased
circulation and slower metabolism and mucosal
repair.
- Older adults are also more likely to be on medications CAUSES OF GASTRITIS
such as nonsteroidal anti-inflammatory drugs
(NSAIDs) that can cause gastritis.
- Gastritis occurs when something damages or
- often the result of infection with the same bacterium
weakens the stomach lining (mucosa). Different things
that causes most stomach ulcers or the regular use of
can trigger the problem, including:
certain pain relievers.
Alcohol abuse:
- aspirin, ibuprofen, or naproxen, alcoholic beverages.
- Chronic alcohol use can irritate and erode the
stomach lining.
NSAIDs should be taken on a full stomach to avoid gastric
Autoimmune disease:
bleeding.
- In some people, the body's immune system attacks
healthy cells in the stomach lining.
MAIN TYPES OF NSAIDS: Medications:
- Steady use of nonsteroidal anti-inflammatory drugs
(NSAIDs) or corticosteroids to manage chronic pain
Ibuprofen alaxan can irritate the stomach lining.
Physical stress:
Naproxen Naprosyn/naproxen - A sudden, severe illness or injury can bring on
gastritis.Often, gastritis develops even after a trauma
that doesn't involve the stomach.
diclofenac Voltaren
- Severe burns and brain injuries are two common
causes.
Bacterial infection:
Celecoxib celebrex
- H. pylori bacteria are the main cause of chronic
gastritis and peptic ulcer disease (stomach ulcers).
mefenamic acid Ponstan - The bacteria break down the stomach's protective
lining and cause inflammation.
Bile reflux:
Etoricoxib arcoxia - The liver makes bile to help you digest fatty foods.
"Reflux" means flowing back.
Indomethacin Indocin - Bile reflux occurs when bile flows back into the
stomach instead of moving through the small
intestine.
MANAGEMENT AND TREATMENT:
TYPES OF GASTRITIS:
How is gastritis treated?
Erosive (reactive):
- Treatment for gastritis varies depending on the cause.
- Erosive gastritis causes both inflammation and
- Certain medications kill bacteria, while others alleviate
erosion (wearing away) of the stomach lining.
indigestion-type symptoms.
- This condition is also known as reactive gastritis.
- Causes include alcohol, smoking, NSAIDs,
Your healthcare provider might recommend:
corticosteroids, viral or bacterial infections and stress
from illnesses or injuries.
Antibiotics: Antibiotics can treat the bacterial infection. You
Non-erosive:
may need to take more than one type of antibiotic for couple of
- Inflammation of the stomach lining without erosion or
weeks.
compromising the stomach lining.
Antacids: Calcium carbonate medications reduce stomach
acid exposure. They can help relieve inflammation. Antacids,
such as Tums® and Rolaids®, also treat heartburn.
Histamine (H2) blockers: Cimetidine (Tagamet*), ranitidine
(Zantac®) and similar medications decrease the production of
stomach acid.
Proton pump inhibitors: These medications, such as
omeprazole (Prilosec®) and esomeprazole (Nexium®), reduce
the amount of acid your stomach produces. Proton pump
inhibitors also treat stomach ulcers and gastroesophageal
reflux disease (GERD).
What are the complications of gastritis?
- If left untreated, gastritis can lead to serious
problems, such as:
Anemia: H. pylori can cause gastritis or stomach ulcers (sores
in your stomach) that bleed, thereby lowering your red blood
counts (called anemia).
Pernicious anemia: Autoimmune gastritis can affect how your
body absorbs vitamin B12.
You're at risk of pernicious anemia when you don't get enough
B12 to make healthy red blood cells.
Peritonitis: Gastritis can worsen stomach ulcers.
Ulcers that break through the stomach wall can spill stomach
contents into the abdomen.
This rupture can spread bacteria, causing a dangerous
infection called bacterial translocation or peritonitis. It also can
lead to a widespread inflammation called sepsis. Sepsis can
be fatal.
Stomach cancer: Gastritis caused by H. pylori and
autoimmune disease can cause growths in the stomach lining.
These growths increase your risk of stomach cancer.
How can I prevent gastritis?
- H. pylori is one of the top causes of gastritis, but
most people don't know they're infected.
- The bacteria are easily transmitted.
- You can lower your risk of infection by practicing good
hygiene, including hand-washing.
- You also can take steps to minimize indigestion and
heartburn.
- These conditions are linked to gastritis.
Preventive measures include:
➔ Avoiding fatty, fried, spicy or acidic foods.
➔ Cutting back on caffeine.
➔ Eating smaller meals throughout the day.
➔ Managing stress.
➔ Not taking NSAIDs.
➔ Reducing alcohol consumption.
➔ Not lying down for 2 to 3 hours after a meal.
What color is stool with upper Gl bleeding?
- Melena is a black, tarry stool that is
caused by Gl bleeding.
- The black color is due to the oxidation of blood
hemoglobin during the bleeding in the ileum and
colon.
- Melena also refers to stools or vomit stained black by
blood pigment or dark blood products and may
indicate upper Gl bleeding.
What color is stool with lower GI bleeding?
- Hematochezia is the passage of fresh blood per
anus, usually in or with stools.
- Hematochezia (passing of red blood from rectum)
usually indicates bleeding from the lower GI tract
Nursing Responsibilities:
1. If patient is vomiting, give antiemetics.
2. Administer IV fluids as ordered to maintain fluid and
electrolyte imbalance.
3. When the patient can tolerate oral feedings, provide a bland
diet that takes into account his food preference. Restart
feedings slowly.
4. Offer smaller, more frequent servings to reduce the amount
of irritating gastric secretions.
5. Help patient identify specific foods that cause gastric upset
and eliminate them from his diet.
6. Administer antacids and other prescribed medications.
7. If pain or nausea interferes with the patient’s appetite,
administer medications or antiemetics about 1 hour before
meals.
8. Monitor the patient’s fluid intake and output and electrolyte
levels.
9. Assess the patient for presence of bowel sounds
10. Monitor the patient’s response to antacids and other
prescribed medications.
11. Monitor the patient’s compliance to treatment and
elimination of risk factors in his lifestyle.
12. Teach the patient about the disorder.
13. Urge the patient to seek immediate attention for recurring
signs and symptoms, such as hematemesis, nausea, or
vomiting.
OUTLOOK / PROGNOSIS
- Most cases of gastritis improve quickly with treatment
- For most people, medications relieve gastritis.
- Your healthcare provider will recommend the most
appropriate treatment based on what's causing
gastritis.
- Antacids reduce stomach acid, while antibiotics clear
up bacterial infections
- You can also make changes like reducing your
alcohol consumption and managing pain without
NSAIDs.
 PEPTIC ULCER DISEASE TYPES OF IBS
Peptic ulcer disease is a condition in which painful sores or
➔ IBS with constipation (IBS-C): Most of your poop is hard
ulcers develop in the lining of the stomach or the first part of
and lumpy.
the small intestine (the duodenum)
➔ IBS with diarrhea (IBS-D): Most of your poop is loose
and watery.
➔ IBS with mixed bowel habits (IBS-M): You have both
hard and lumpy bowel movements and loose and watery
movements on the same day.

What triggers IBS?

➔ If you have IBS, you may have noticed that certain things
trigger symptoms.
➔ Common triggers include some foods and medication.
➔ Emotional stress can also be a trigger.
➔ Some researchers suggest that IBS is the gut's response
to life's stressors.
What are IBS symptoms?
➔ Abdominal pain or cramps, usually in the lower half of the
abdomen
➔ Bloating
➔ Bowel movements that are harder or looser than usual.
NURSING RESPONSIBILITIES: ➔ Diarrhea, constipation or alternating between the two.
➔ Excess gas
Encourage ➔ Mucus in your poop (may look whitish)
- Encourage patient to eat regular meals in a relaxed Causes:
setting and to avoid overeating. ➔ Muscle contractions in the intestines
Explain ➔ Inflammation in the intestines
- Explain that smoking may interfere with ulcer ➔ Severe infection
healing; refer patient to programs to assist with ➔ Changes in microflora
smoking cessation. Dietary changes:
Alert ➔ Increase fiber in your diet - eat more fruits, vegetables,
- Alert patient to signs and symptoms of grains, and nuts.
complications to be reported. ➔ Add supplemental fiber to your diet, such as Metamucil@
or Citrucel®.
➔ Drink plenty of water - eight 8-ounce glasses per day.
DISORDERS OF INTESTINAL MOTILITY ➔ Avoid caffeine (from coffee, chocolate, teas and sodas).
➔ Limit cheese and milk.
➔ Irritable Bowel Syndrome ➔ Lactose intolerance is more common in people with IBS.
➔ Short Bowel Syndrome Make sure to get calcium from other sources, such as
➔ Lactose Intolerance broccoli, spinach, salmon or supplements.
Nursing Responsibilities:
➔ Educate and encourage eating a well-balanced, high-fiber
IRRITABLE BOWEL SYNDROME (IBS)
diet;
- Irritable bowel syndrome, or IBS, is a group of ➔ Avoid gas-forming foods; and avoid fluid intake with meals
symptoms that affect your digestive system. because it causes abdominal distention.
- It's a common but uncomfortable gastrointestinal ➔ Adhering to a schedule of regular work and rest periods
disorder. ➔ Participating in regular exercise, which reduces anxiety
- People with IBS get excessive gas, abdominal pain and increases intestinal motility.
and cramps.
- Is a group of symptoms that affect your digestive
system
- a common disorder that affects the stomach and
intestines
- characterized by abdominal pain and altered bowel
habit in the absence of a specific and unique organic
pathology
 SHORT BOWEL SYNDROME (IBS)
➔ Short bowel syndrome is a condition in which your body is
unable to absorb enough nutrients from the foods you eat
because you don't have enough small intestine.
➔ The small intestine is where the majority of the nutrients
you eat are absorbed into your body during digestion
CAUSES:
➔ Adults typically develop SBS after massive surgical
resection or significant damage to the small intestines
➔ having parts of your small intestine removed during or
being born with some of the small intestine missing
damaged.
➔ Some children are born with an abnormally short small
intestine or with part of their bowel missing, which cause
short bowel syndrome.
What organs are affected by short bowel syndrome?
➔ Your bowels are made up of two parts -
➔ the large intestine, also called the colon, and the small
intestine.
➔ Short bowel syndrome usually affects people who've had a
lot of their small intestines removed.
➔ Without this part, your body can't get enough nutrients and
water from the food you eat,
Signs/symptoms:
➔ Diarrhea.
➔ Greasy, foul-smelling stools.
➔ Fatigue.
➔ Weight loss.
➔ Malnutrition.
➔ Swelling (edema) in the lower extremities.
What foods are good for short bowel syndrome?
Foods with low fiber, such as:
➔ Puffed wheat, puffed rice, corn flakes, Special K, and other
cereals containing 1 gram or less of fiber per serving.
➔ Cream of wheat or rice.
➔ Farina.
➔ White rice
➔ White bread, matzoh, and Italian bread without seeds.
➔ Regular pasta (not whole wheat)
➔ Baked or mashed potatoes without skin
➔ Matzah, matzo, or mazzah is an unleavened flatbread that
is part o Jewish cuisine and forms an integral element of
the Passover festival, during which chametz is forbidden.
➔ As the Torah recounts, God commanded the Israelites to
eat only unleavened bread during the seven-day Passover
festival.
How do you treat short bowel syndrome?
Short bowel syndrome treatment may include:
➔ Nutritional therapy.
➔ People with small bowel syndrome will need to follow a
special diet and take nutritional supplements.
➔ Some people may need to get nutrition through a vein
(parenteral nutrition) or a feeding tube (enteral nutrition) to
prevent malnutrition.
Nursing Responsibilities:
➔ Nurses will educate patients on risk factors, symptoms,
and management of their condition.
➔ Encourage eating small, frequent meals and drinking fluid
➔ taking nutritional supplements (dependent)
➔ using medications to treat diarrhea (dependent)
LACTOSE INTOLERANCE
➔ People with lactose intolerance are unable to fully digest
the sugar (lactose) in milk.
➔ As a result, they have diarrhea, gas, and bloating after
eating or drinking dairy products.
➔ The condition, which is also called lactose malabsorption,
is usually harmless, but its symptoms can be
uncomfortable.
Symptoms:
➔ Diarrhea.
➔ Nausea, and sometimes, vomiting.
➔ Stomach cramps,
➔ Bloating.
➔ Flatulence
What are the 4 types of lactose intolerance?
➔ Primary lactose intolerance (normal result of aging) This
is the most common type of lactose intolerance.
➔ Secondary lactose intolerance (due to illness or injury)
➔ Congenital or developmental lactose intolerance
(being born with the condition)
➔ Developmental lactose intolerance
Here are some dairy products that you may want to avoid as
part of a lactose-free diet:
➔ milk - all types of cow's milk, goat's milk, and buffalo milk.
➔ cheese - especially soft cheeses, such as cream cheese,
cottage cheese, mozzarella, and ricotta.
➔ butter
➔ yogurt
➔ ice cream, frozen yogurt, and dairy-based sherbet.
buttermilk.
What foods and drinks contain lactose?
➔ bread and other baked goods, such as pancakes, biscuits,
cookies, and cakes.
➔ processed foods, including breakfast cereals, instant
potatoes, soups, margarine, salad dressings, and flavored
chips and other snack foods.
➔ processed meats, such as bacon, sausage, hot dogs, and
lunch meats.
 MALABSORPTION SYNDROME Hypofunction
- A decrease in hormone production by the peripheral
Malabsorption syndrome is a digestive disorder that prevents endocrine gland with a resulting increase in production of
your body from effectively absorbing nutrients from your food. pituitary regulating hormone
It has many causes, but most of them involve damage to the - Can lead to peripheral endocrine gland hyperplasia.
mucous lining of your small intestine, where most absorption
happens Thyroid Gland
- Helps to control energy level and growth
CAUSES:
HYPOTHYROIDISM
Factors that may cause malabsorption syndrome include: damage ● Fatigue
to the intestine from infection, inflammation, trauma (injury), or ● Weight gain
surgery. ● Cold intolerance
prolonged use of antibiotics. ● Slow heart rate
other conditions such as celiac disease, Crohn's disease, chronic ● Heavy menstrual bleeding
pancreatitis, or cystic fibrosis ● Constipation

Crohn's disease is a type of inflammatory bowel disease (IBD).

- It causes swelling of the tissues (inflammation) in your
digestive tract, which can lead to abdominal pain, severe
diarrhea, fatigue, weight loss and malnutrition.

Cystic fibrosis (CF) is an inherited disorder that causes severe

damage to the lungs, digestive system and other organs in the
body.
- Cystic fibrosis affects the cells that produce mucus,
sweat and digestive juices. These secreted fluids are
normally thin and slippery.

What is the classic symptom of malabsorption syndrome?

Chronic diarrhea is the most common symptom and is what

usually prompts the evaluation of the patient.

Steatorrhea—fatty stool, the hallmark of malabsorption—occurs

when > 7 g/day of fat are excreted. Steatorrhea causes ➔ can affect the heart and circulatory system
foul-smelling, pale, bulky, and greasy stools. ➔ Hypothyroidism happens when the thyroid gland doesn't
make enough thyroid hormone.
How do you fix malabsorption syndrome? ➔ Underactive thyroid hormone
Treatment for malabsorption syndrome depends on the cause.
You may be put on a special diet of foods that are more easily Causes:
digested and absorbed.
➔ Radiation therapy to the neck area
You may also be given supplements to make up for nutrients that ➔ Radioactive iodine treatment
aren't being absorbed well. ➔ Use of certain medications
➔ Thyroid surgery
➔ Too little iodine in the diet
➔ Pregnancy
➔ Problems with the thyroid at birthPituitary gland damage
or disorder
ENDOCRINE SYSTEM
Early warning signs:
The endocrine system is a chemical messenger system comprising
➔ Fatigue
feedback loops of the hormones released by the internal glands of
➔ Weight gain
an organism directly into the circulatory system, regulating distant
➔ Slowed heart rate
target organs. In humans, the major endocrine glands are the
➔ Sensitivity to cold
thyroid gland and the adrenal glands. In vertebrates, the
hypothalamus is the neural control center for all endocrine Lab test:
systems. The study of the endocrine system and its disorders is
known as endocrinology. Endocrinology is a branch of internal ➔ TSH - measures the amount of thyroid stimulating
medicine. hormone (TSH) in your blood. TSH is produced by the
pituitary gland.
Endocrine Diseases ➔ T4 - A thyroxine test measures the level of thyroxine (T4)
in the blood. T
•Hypofunction – underproduction Stress may exacerbate an underlying thyroid condition
•Hyperfunction – overproduction
Treatment: ➔ Obtain ECG (atrial arrhythmias may occur in
hyperthyroidism)
➔ Medication - levothyroxine ➔ Teach the patient to relax.

Nursing Responsibilities: Treatment:

➔ Promote rest.
Anti-thyroid medicine
➔ Protect against coldness.
- These medications slowly ease symptoms of
➔ Avoid external heat exposure
hyperthyroidism by preventing the thyroid gland from
➔ Mind the temperature.
making too many hormones. ...
➔ Increase fluid intake.
Beta blockers
➔ Provide foods high in fiber.
- These medicines don't affect thyroid hormone levels.
➔ Manage respiratory symptoms.
Radioiodine therapy
➔ Pulmonary exercises.
- The thyroid gland takes up radioiodine. ...
Thyroidectomy
Possible Causes:
➔ Graves disease (most common)
➔ Inflammation (thyroiditis) of the thyroid due to viral
infections
➔ some medicines, or after pregnancy (common)
➔ Taking too much thyroid hormone (common)
➔ Noncancerous growths of the thyroid gland or pituitary
gland (rare)

HYPERTHYROIDISM
- A condition that occurs when the thyroid gland makes
more thyroid hormones than the body needs
- an overactive thyroid
- Hyperthyroidism speeds up the body's metabolism

Symptoms of an overactive thyroid

➔ 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.
➔ diarrhoea.

Nursing Responsibilities

➔ Monitor vital signs, especially heart rate and blood

pressure (both increase in hyperthyroidism)
➔ Ask if the patient has chest pain (Due to increased heart
work)
➔ Listen to the heart for murmurs.