1.

At the clinic, a patient with

hyperthyroidism would report
which of the following:
(Select all that apply)
a. Excessively cold
b. Swollen neck
c. I ncreased appetite
d. Decreased heart rate
e. Weight loss

2. A nurse receives lab results from a
patient with suspected
hyperthyroidism. Which of the
following hormone results would
indicate this?
(Select all that apply)
a. Decreased T4 levels
b. Elevated T4 levels
c. TSH level of 1.0 mU/L
d. Decreased TSH levels
e. Decreased T3 levels.

3. Which nursing diagnosis takes
highest priority for a female client
with hyperthyroidism?
a. Risk for imbalanced nutrition: More
than body requirements related to
thyroid hormone excess.
b. Risk for impaired skin integrity related
to edema, skin fragility, and poor
wound healing.
c. Body image disturbance related to
weight gain and edema
d. I mbalance nutrition: Less than body
requirements related to thyroid
hormone


Ann Puruleski
Nursing 300
EBP Brochure
Hyperthyroidism
NCLEX Questions







Nursing Diagnoses
Activity intolerance related to exhaustion and fatigue.
Outcomes for this diagnosis: energy conservation;
endurance; self-care; mobility.
Anxiety R/T increased stimulation, loss of control.
Outcomes: verbalize and identify symptoms of anxiety.
Identify ways to control anxiety. Demonstrate ability to
self-assure.
Insomnia R/T anxiety, excessive sympathetic discharge.
Outcomes include: fall asleep without difficulty, wake up
less frequently during the night, awaken refreshed and not
fatigued during the day.
Imbalanced nutrition: less than body requirements R/T
increased metabolic rate, increased gastrointestinal
activity.
Outcomes: progressively gain weight toward desired goal,
identify nutritional requirements, consume adequate
nourishment, and to be free of signs of malnourishment.
Significance to Nursing
The legal and ethical responsibilities of the nurse would be
to educate the patient on this disease. Also the nurse
should educate the patient on the medications and to
make sure there are no medication errors. The nurse will
need to discuss the patients diet as well. The nurse should
assess the patient for any reaction to the medications, and
whether the patient is experiencing any pain. Also, the
nurse should see if the patient has any edema, possibly
going through a thyroid storm, is cold, or has had any
weight loss or menstrual changes that would relate to
hyperthyroidism. The nurse needs to be an advocate for
the patient and maintain HIPAA. If incidence increases it
would impact nursing because there would be a new
demand of costs, as well as further education for nurses
on this disease. Nurses would need to increase their
knowledge on this disease and know more about the
medications that these patients would receive. Healthcare
providers that would be involved in a patient with
hyperthyroidism include nurses, pharmacists,
doctor/physician, endocrinologist, and possibly a
nutritionist to help manage their diet. Another possible
healthcare specialist would include an otolaryngologist.

basal metabolic rate, which leads to
weight loss. A person with this disease
will experience increased sweating,
heat intolerance, diarrhea, and an
increased appetite. People who are
more at risk would be if they are
female, had a baby in the last 6
months, have a family history of
hyperthyroidism, if someone smokes,
consume a lot of food containing
iodine, and if someone has an
autoimmune disease. Another risk
factor is if you are over the age of 60,
and consume a lot of iodine.
Clinical Manifestations and Potential
Complications
Complications that could develop for
the patient include heart problems,
eye problems, brittle bones, thyrotoxic
crisis and even in rare cases red,
swollen skin. Heart problems would
include a rapid heart rate and
congestive heart failure. Thyrotoxic
crisis is when symptoms become so
intense and sudden that it can cause
delirium and immediate medical
attention is necessary. It is manifested
by signs of hypermetabolism, toxic
goiter, and exophthalmos.
Exophthalmos is the presence of
protruding eyes, decreased blinking
and eye movements. Thyrotoxic crisis,
also known as toxic storm is life
threatening in a patient with
uncontrolled hyperthyroidism that can
result in hyperthermia, tachycardia, and
heart failure.
Lifespan and Cultural Consideration
Hyperthyroidism can occur in newborns
who have a mother who has Graves
disease. In newborns hyperthyroidism is
usually only temporary. This is because the
thyroid hormones can cross the placenta
and cause the baby to produce excess
thyroid hormones. If a baby is left
untreated, it can be fatal. In children it is
found that only 1 in 5,000 children have
hyperthyroidism. The symptoms are about
the same as that of an adult or older adult,
the child will be anxious, have a rapid
heartbeat, and irritability.
Hyperthyroidism can also cause
accelerated growth in the child and delay
puberty. In girls that have started their
periods, this disease might cause their
period to stop coming altogether. It has
been found that women who smoke are
twice as likely to develop Graves disease.
It does not seem to be more common in
specific ethnic groups.
References
Ackley, B. J., & Ladwig, G. B. (2011). Mosbys
Guide to Nursing Diagnosis. (3
rd
ed.).
Maryland Heights, Mo:
Mosby/Elsevier.
Deglin, J. H., & Vallerand, A. H. (2012).
Diseases and Disorders (12th ed.)
[Mobile application software].
Retrieved from
http://www.skyscape.com/estore/produ
ctdetail.aspx?productid=219
Women who smoke have nearly twice the
risk of developing Graves'
hyperthyroidism than nonsmokers.
(2005). AHRQ Research Activities,
(302), 13.
Explanation of Disease
Hyperthyroidism is a condition caused
by the overproduction of thyroid
hormone by the thyroid gland. There
are two hormones, triiodothyronine
and thyroxine, more commonly known
as T3 and T4 that are produced in the
thyroid gland. The thyroid gland
regulates the bodys metabolism
under the control of the thyroid
stimulating hormone. Another word
that is associated with
hyperthyroidism is Thyrotoxicosis
which means its a condition that
results from excess thyroid hormones.
Hyperthyroidism and thyrotoxicosis
are interchangeable. A primary disease
that occurs because of
hyperthyroidism is Graves Disease,
which accounts for 80% of cases of
hyperthyroidism. Hyperthyroidism
occurs more commonly in women who
are over the age of 30. In
hyperthyroidism there is an increased
Hyperthyroidism