Common cause is Graves’ disease, also known as toxic diffuse goiter
S/S include: personality changes such as irritability, agitation and mood swings,
... [Show More] nervousness and fine
tremors of the hands, heat intolerance, weight loss, smooth, soft skin and hair, palpitations, cardiac
dysrhythmias such as tachycardia or atrial fibrillation, diarrhea, protruding eyeballs (exophthalmos) may
be present, diaphoresis (sweating), hypertension, enlarged thyroid gland (goiter)
Nursing Considerations: Provide adequate rest, provide a cool and quiet environment, provide a highcalorie diet, obtain daily weight, avoid administration of stimulants, administer sedatives as prescribed,
administer antithyroid medications, administer blood pressure medication for tachycardia, prepare for
thyroidectomy if prescribed
Hypothyroidism- Hyposecretion of thyroid hormones (T3 and T4) Characterized by a decreased rate of
body metabolism
Causes: autoimmune disease, treatment for hyperthyroidism, radiation therapy, thyroid surgery, certain
medications
S/S: lethargy, fatigue, weakness, muscle aches, paresthesias, intolerance to cold, weight gain, dry skin and
hair and loss of body hair, bradycardia, constipation, generalized puffiness and edema around the eyes
and face (myxedema), forgetfulness and loss of memory, menstrual disturbances, cardiac enlargement,
tendency to develop heart failure, goiter may or may not be present
Hyperparathyroidism- Hypersecretion of parathyroid hormone (PTH)
Causes: Tumor, Hyperplasia, Genetics; secondary causes-severe calcium or vitamin D deficiency, chronic
kidney failure
S/S: Hypercalcemia and hypophosphatemia, fatigue and muscle weakness, skeletal pain and tenderness,
bone deformities that result in pathological fractures, anorexia, nausea, vomiting, epigastric pain, weight
loss, constipation, hypertension, cardiac dysrhythmias, renal stones
Nursing Considerations: Monitor vital signs, particularly blood pressure; monitor for cardiac
dysrhythmias, monitor for intake and output and for signs of renal stones, monitor skeletal pain, move the
patient slowly and carefully; encourage fluid intake, administer furosemide (Lasix) as prescribed to lower
calcium levels, administer phosphates, which interfere with calcium reabsorption as prescribed,
administer calcitonin as prescribed to decrease the skeletal calcium release and increase renal excretion of
calcium, monitor calcium and phosphorus levels, prepare the patient for parathyroidectomy as prescribed
Hypoparathyroidism-Hyposecretion of parathyroid hormone (PTH)
Can occur following a thyroidectomy because of removal of parathyroid tissue
S/S: Hypocalcemia and hyperphosphatemia, numbness and tingling in the face, muscle cramps and
cramps in the abdomen or extremities, positive Trousseau’s and Chvostek’s sign, signs of overt tetany
such as bronchospasm, laryngospasm, carpopedal spasm, dysphagia, photophobia, cardiac dysrhythmias,
seizures; hypotension, anxiety, irritability, depression
Nursing Considerations: Monitor vital signs, monitor for signs of hypocalcemia and tetany, initiate
seizure precautions, place a tracheostomy set, oxygen and suctioning equipment at bedside, prepare to
administer calcium gluconate intravenously for hypocalcemia, provide a high-calcium, low-phosphorus [Show Less]