Hyperthyroidism Lecture Notes

Introduction

• Speaker: Sarah, Registered Nurse
• Focus: NCLEX review on hyperthyroidism
• Topics Covered:
  • Signs and symptoms
  • Causes
  • Nursing interventions
  • Pathophysiology
  • Pharmacological aspects
• Additional Resources:
  • Free quiz on hyper vs hypothyroidism available on RegisteredNurseRN.com
  • Upcoming video on hypothyroidism

What is Hyperthyroidism?

• Definition: High secretion of thyroid hormone
• Diagnosis: Blood test to check T3, T4, TSH levels

Pathophysiology

• Thyroid Gland Location: Below the larynx, butterfly-shaped
• Parathyroid Gland: Regulates calcium levels
• Thyroid Hormones: T3 and T4, essential for metabolism, temperature regulation, growth, and development
• Iodine: Essential for thyroid hormone production (sources: seafood, eggs, dairy)

Functions of T3 and T4

• Calorie Burning: Increases metabolism
• Cell Replacement: Determines the rate of cell turnover
• Digestion: Affects the speed of food digestion
• Sympathetic Nervous System: Enhances alertness, reflexes
• Temperature, Heart Rate, Blood Pressure: Regulates increases
• Thyroid Stimulating Hormone (TSH): Produced by anterior pituitary gland, stimulates thyroid hormone release

Negative Feedback Loop

• Hypothalamus: Releases TRH (thyrotropin-releasing hormone)
• Anterior Pituitary Gland: Releases TSH
• Thyroid Gland: Releases T3 and T4

Signs and Symptoms of Hyperthyroidism

• Weight loss
• Heat intolerance
• Increased heart rate and blood pressure
• Diarrhea
• Smooth hair and soft skin
• Risk for cardiac dysrhythmias (e.g., atrial fibrillation)
• Personality changes (moodiness, irritability, insomnia)

Causes of Hyperthyroidism

• Graves’ Disease: Autoimmune, genetic, characterized by protruding eyeballs and pretibial myxedema
• Toxic Nodular Goiter: Nodules growing on the thyroid, non-autoimmune
• Thyroiditis: Inflammation of the thyroid
• Excessive Iodine Consumption: Leads to excessive thyroid hormone production

Treatment Options

• Anti-Thyroid Medications: Stop synthesis of T3 and T4 (e.g., Methimazole, PTU)
  • Side effects: Agranulocytosis, aplastic anemia
  • Patient education: Do not stop abruptly; monitor for toxicity
• Radioactive Iodine: Destroys thyroid gland, permanent solution, not for pregnant/nursing women
  • Side effects: Taste changes, nausea, swollen glands
• Thyroidectomy: Surgical removal of the thyroid
  • Risks: Thyroid storm, parathyroid gland problems, respiratory distress
  • Post-op care: Semi-fowler's position, cough and deep breathing
• Beta Blockers: Manage symptoms like fast heart rate and heat intolerance

Nursing Interventions

• Maintain a cool, quiet environment
• Monitor weight, heart rate, blood pressure, EKG
• Educate on medication adherence and side effects
• Watch for thyroid storm symptoms

Conclusion

• Next Steps: Watch the hypothyroidism video, take the quiz
• Website: RegisteredNurseRN.com for more resources