NR 507 Week 7 Final Presentatio Hyperthyroidism, Assignments of Nursing

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Hyperthyroidism

CHAMBERLAIN COLLEGE OF NURSING NR507: LEADERSHIP AND ROLE OF THE APN

WHAT IS HYPERTHYROIDISM?

Hyperthyroidism is the excessive

concentration of thyroid hormones in the

tissues caused by increased production of

thyroid hormones, excessive release of

thyroid hormones, of an endogenous or

exogenous extra-thyroidal source.

Adrenergic – most frequent S/S Palpitations, tachycardia, anxiety, tremors, jitteriness, diaphoresis, intolerance for heat, frequent stare, Cardiovascular , rapid and or irregular pulse (in atrial fibrillation), dyspnea, orthopnea and peripheral edema seen in heart failure. Cutaneous - Onycholysis (Plummer nails), patchy or generalized hyperpigmentation usually of the face and neck..

Initial Presenting Signs and Symptoms Part 1

Initial Presenting Signs and Symptoms Part 2 Hypermetabolism –common weight loss in spite of increased appetite, fever if the patient is in thyroid storm. Neuromuscular Sharp peripheral reflexes with accelerated relaxation phase and weakness of proximal muscles Neuropsychiatric Anxiety, rapid, pressured speech, insomnia, psychosis with severe cases. Ocular Increased lacrimation, incomplete closure of the eyes when sleeping, photophobia, increased eye sensitivity when exosed to wind or smoke, feeling of grit or foreign body in the eyes

ETIOLOGY OF HYPERTHYRODISM

 Graves disease, is the most common

cause of hyperthyroidism in the United States Process- The disease presents an autoimmune process in which antibodies stimulate the TSH receptor thus leading to an overproduction of thyroid hormones Risk factors Female have higher incidence and personal or family history of an autoimmune disorder

ETIOLOGY OF HYPERTHYRODISM

 Toxic adenoma (Plummer

disease)

Process- Somatic mutation in TSH receptor or Gs alpha gene in a thyroid nodule

Risk Factors - nodules arise from the frequent replication of clonogenic cells that leads to a somatic activating mutation of TSH receptors..

ETIOLOGY OF HYPERTHYRODISM (Less Common Causes)

Drug-induced thyroiditis

Process- Overproduction of thyroid hormones (amiodarone-induced thyrotoxicosis type 1) or release of preformed thyroid hormones (amiodarone-induced thyrotoxicosis type 2, interferon alfa, interleukin-2, or lithium)

ETIOLOGY OF HYPERTHYRODISM (Less Common Causes)

 Hyperemesis gravidarum High level of β- hCG stimulates TSH receptors Process- Hyperemesis gravidarum High level of β-hCG stimulates TSH receptors

 Subacute granulomatous (de Quervain) thyroiditis Process- Painful inflammation of the thyroid gland caused by viral infection, often with

Signs and Symptoms

Adrenergic – most frequent S/S Palpitations, tachycardia,

anxiety, tremors, jitteriness, diaphoresis, intolerance for

heat, frequent stare,

Cardiovascular , rapid and or irregular pulse (in atrial

fibrillation), dyspnea, orthopnea and peripheral edema

seen in heart failure.

Cutaneous - Onycholysis (Plummer nails), patchy or

generalized hyperpigmentation usually of the face and

neck..

Signs and Symptoms

Hypermetabolism –common weight loss in spite of

increased appetite, fever if the patient is in thyroid storm.

Neuromuscular Sharp peripheral reflexes with

accelerated relaxation phase and weakness of proximal

muscles

Neuropsychiatric Anxiety, rapid, pressured speech,

insomnia, psychosis with severe cases.

Ocular Increased lacrimation, incomplete closure of the

eyes when sleeping, photophobia, increased eye

sensitivity when exosed to wind or smoke, feeling of grit

Diagnosing of Hyperthyroidism

 Radioiodine uptake test

 Thyroid scan

 Thyroid Ultrasound

Pharmacological Treatment of Hyperthyroidism

 Anti-thyroid medications

 Beta-Blockers

 Assessment and Evaluation of patient Plan of treatment; Teaching & Education Coordination of care if appropriate

Summary of the care and implications for the Advanced Practice Nurse

Summary /Conclusion

Hyperthyroidism

The power point presented the most common causes of

Hyperthyroidism and risk factors. The presentation noted

the most common signs and symptoms that most

patients would present to the medical provider. For the

Advance Practice Nurse early detection and

diagnosing is the key in medical management and

treatment of the disorder of Hyperthyroidism. Educating

the patients is very important, diagnosing can be done

with simple test and is based on the association of

thyrotoxicosis, diffuse goiter and ophthalmopathy.