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Hyperthyroidism is the second most prevalent endocrine disorder next to diabetes mellitus. According to Tierney, et. al. on 2005, it affects women eight times more frequently than men, with onset usually between the second and fourth decades. Thyroid hormones facilitate metabolism. Consequently, if there is an abnormally high level of thyroid hormones (both T3 and T4) in the blood, there will be an increased in demand of oxygen, fast metabolism, and increased vital signs.

Graves’ disease, an autoimmune disorder which causes abnormal stimulation of thyroid gland is the most common cause of hyperthyroidism.

In addition, tumor in the pituitary gland, emotional shock, stress, and infection as well as excessive ingestion of thyroid hormones can precipitate the disorder. 

Clinical Manifestations
1. Due to increased oxygen consumption: insomnia, restlessness, fatigue, irritability, tremors, nervousness, and hyperactivity
2. Due to heat intolerance: sweating, flushed and warm skin
3. Due to increased metabolic rate: weight loss in spite of increased appetite
4. Due to increased cellular metabolism: increased vital signs and peristaltic movement
5. Exopthalmus

Diagnostic  Findings
1. Enlarged thyroid gland
2. Thrill may be palpated and a bruit is heard at the thyroid arteries –sign of increased blood flow to the area
3. Decreased in serum TSH, increased free T4, and increase in radioactive iodine uptake

Medical Management
1. Antithyroid agents – lifetime
2. Radioactive iodine therapy – destroy overactive thyroid cells
3. Surgery 

Nursing Interventions

1.To improve nutritional status

  • Small, frequent feedings (up to 6 meals a day)
  • Encourage high-calorie and high-protein foods
  • Avoidance of highly seasoned, coffee, cola, tea, and alcohol
  • Weight monitoring

2.To enhance coping measures

  • Emphasize that symptoms are going to disappear with treatment although exopthalmus is irreversible.
  • Use calm, unhurried approach
  • Minimizing stressful situations for the client by providing a room conducive for resting

3.To maintain normal body temperature

  • Air-conditioned room is recommended as patient usually finds a normal room temperature too warm
  • Let patient wear loose and light clothes
  • Cool baths and cool fluids should be encouraged

Hyperthyroidism Pathophysiology and Schematic Diagram

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Iris is the recipient of Florence Nightingale Award in her class. She has genuine passion and interest in Endocrinology, Renal Nursing, and Nursing Research. Decided that the Nursing profession called her, she is serving the nursing community through writing or blogging for health-related educational websites and assisting students with their undergraduate thesis.