NR 507 Week 7 Final Presentation Hyperthyroidism 2023, Exams of Nursing

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Hyperthyroidism

NR 507 Week 2

C H A M B E R L A I N C O L L E G E O F N U R S I N G N R 5 0 7 : L E A D E R S H I P A N D R O L E O F T H E A P N M A R C H 1 6 , 2 0 1 9

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,

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

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.