Iloilo Doctors’ College

College of Nursing
West Avenue, Molo, Iloilo City

Case Analysis
On
Hyperthyroidism

In Partial Fulfillment
for the requirements in
Related Learning Experience 118/119

Submitted By:
JECELLE DE LA PUERTA

Submitted To:
RENNEL L. SOBRETODO, RN, MAN
Clinical Instructor

NOVEMBER 2023
 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

I. INTRODUCTION

Hyperthyroidism occurs when the thyroid produces excess thyroid hormone. The thyroid gland is
located in the neck and produces several hormones, which control metabolism, or the way cells
use energy. Hyperthyroidism is a common disorder affecting over two million Americans, most of
whom are women. Clinical hyperthyroidism, also called thyrotoxicosis, is caused by the effects of
excess thyroid hormone and can
be triggered by different disorders.
Etiologic diagnosis influences
prognosis and therapy. The
prevalence of hyperthyroidism in
community-based studies has been
estimated at 2 percent for women
and 0.2 percent for men. As many
as 15 percent of cases of
hyperthyroidism occur in patients
older than 60 years.

According to National Nutrition Council, the thyroid is a small, butterfly-shaped gland in the front
of your neck. Thyroid hormones control the way the body uses energy, so they affect nearly every
organ in your body, even the way your heart beats. If left untreated, hyperthyroidism can cause
serious problems with the heart, bones, muscles, menstrual cycle, and fertility. During pregnancy,
untreated hyperthyroidism can lead to health problems for the mother and baby. Hyperthyroidism
presents with multiple symptoms that vary according to the age of the patient, duration of illness,
magnitude of hormone excess, and presence of comorbid conditions. Symptoms are related to the
thyroid hormone’s stimulation of catabolic enzymopathy activity and catabolism, and
enhancement of sensitivity to catecholamines. Older patients often present with a paucity of classic
signs and symptoms, which can make the diagnosis more difficult. Thyroid storm is a rare
presentation of hyperthyroidism that may occur after a stressful illness in a patient with untreated
or undertreated hyperthyroidism and is characterized by delirium, severe tachycardia, fever,
vomiting, diarrhea, and dehydration.

The most common cause of the condition is Graves' disease, which accounts for 85 percent of
cases. Graves’ disease is the most common cause of hyperthyroidism, accounting for 60 to 80
percent of all cases. It is an autoimmune disease caused by an antibody, active against the thyroid-
stimulating hormone (TSH) receptor, which stimulates the gland to synthesize and secrete excess
thyroid hormone. It can be familial and associated with other autoimmune diseases. An infiltrative
ophthalmopathy accompanies Graves’ disease in about 50 percent of patients. Hyperthyroidism
also can result from nodular goiter, a condition in which an inflammation of the thyroid occurs due
to viral infections or other causes, ingestion of excessive amounts of thyroid hormone, and
ingestion of excessive iodine.

According to the 2012 Philippine Thyroid Diseases Study (PhilTiDes-1), the prevalence of thyroid
function abnormalities in the Philippines is 8.53% among the adult population, and among the
thyroid disorders, goiter is most common with a prevalence rate of 10.12%. A survey conducted
by the National Institute of Diabetes and Digestive and Kidney Diseases showed that about 1.2
percent of people in the United States have hyperthyroidism. That’s a little more than 1 person out
of 100. The survey also shows that women are 2 to 10 times more likely than men to develop
hyperthyroidism. You are more likely to have hyperthyroidism if you have a family history of
thyroid disease.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

II. TABLE OF CONTENTS

INTRODUCTION 2

RISK FACTORS 4

PATHOPHYSIOLOGY 5

DIAGNOSTIC EXAMS/TESTS 7

MEDICAL OR SURGICAL MANAGEMENT 10

DRUG STUDY NO. 1: Prophythiouracil 11

DRUG STUDY NO. 2: Methimazole 13

DRUG STUDY NO. 3: Propanolol 14

NURSING CARE PLAN 15

NURSING MANAGEMENT/NURSING CONSIDERATIONS 19

REFERENCES 20

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

III. RISK FACTORS

AGE and GENDER

Hyperthyroidism is more common in women than in men, and it often occurs between the
ages of 20 and 40.

FAMILY HISTORY

There is a genetic component to thyroid disorders, and individuals with a family history of
thyroid problems may have an increased risk.

AUTOIMMUNE DISORDERS

Conditions such as Graves' disease, an autoimmune disorder, are a common cause of

hyperthyroidism.

RADIATION EXPOSURE

Exposure to certain types of radiation, especially during medical treatments involving the
head and neck, may increase the risk of hyperthyroidism.

IODINE INTAKE

Excessive iodine intake, either through diet or medication, can contribute to hyperthyroidism.

CERTAIN MEDICATIONS

Some medications, such as amiodarone (used for heart conditions) and lithium (used for
psychiatric disorders), may affect thyroid function and potentially lead to hyperthyroidism.

THYROID NODULES

The presence of thyroid nodules or goiter may contribute to hyperthyroidism.

PREGNANCY

Hyperthyroidism can sometimes occur during pregnancy, and women with a history of
thyroid problems may be at higher risk.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

IV. PATHOPHYSIOLOGY

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

Hyperthyroidism is a thyroid disorder characterized by an overactive thyroid gland, primarily

driven by autoimmune mechanisms. Genetic predisposition plays a role, with a familial tendency
for thyroid disorders increasing susceptibility. In most cases, hyperthyroidism stems from
autoimmune stimulation, notably in conditions like Graves’ disease.

As shown in the illustration, the immune system mistakenly produces antibodies that bind to
thyroid-stimulating hormone (TSH) receptors on thyroid cells. This results in uncontrolled and
persistent stimulation of the thyroid gland, leading to the excessive production of thyroid
hormones, predominantly thyroxine (T4) and triiodothyronine (T3). The disrupted negative
feedback loop, which would normally regulate thyroid hormone levels, contributes to sustained
hyperthyroidism. Clinically, individuals with hyperthyroidism exhibit a hypermetabolic state,
presenting symptoms such as weight loss, increased heart rate, anxiety, and heat intolerance.
Additionally, prolonged stimulation may cause the thyroid gland to enlarge, forming a goiter.
While genetic factors set the stage, precipitating factors such as stressful events or certain
medications can trigger or exacerbate this intricate pathophysiological cascade, further influencing
the clinical manifestation of hyperthyroidism.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

V. DIAGNOSTIC TESTS/EXAMS

THYROID FUNCTION BLOOD TEST

A thyroid function blood test typically includes measuring levels of thyroid hormones (T3 and T4)
and thyroid-stimulating hormone (TSH).

In hyperthyroidism, an overactive thyroid, the thyroid gland produces excessive amounts of

thyroid hormones. The blood test helps determine if thyroid hormone levels are elevated, providing
crucial information for diagnosing hyperthyroidism.

Specifically:

1. TSH (Thyroid-Stimulating Hormone): Produced by the pituitary gland, elevated TSH

levels suggest the thyroid is not producing enough hormones, while low levels can indicate
an overactive thyroid.
2. T3 (Triiodothyronine) and T4 (Thyroxine): These are the main thyroid hormones.
Elevated levels of T3 and T4 indicate hyperthyroidism.

These blood tests offer a comprehensive

view of thyroid function, aiding in the
diagnosis and management of
hyperthyroidism. Regular monitoring
through these tests helps assess the
effectiveness of treatment if prescribed.

RADIOACTIVE IODINE UPTAKE TEST

RAIU, or Radioactive Iodine Uptake, is a nuclear medicine test used to measure the amount of
radioactive iodine taken up by the thyroid gland. It’s primarily employed to assess thyroid function.
In hyperthyroidism, where the thyroid is overactive and produces excessive thyroid hormones,
RAIU helps determine the degree of glandular activity.

Using radioactive material, the test can assess, diagnose, and treat certain diseases. It can also show
if treatment is working in body. Its results tend to be more accurate than other diagnostic tools,
including exploratory surgery. An RAIU test can produce results and invaluable information that
is not easily accessible with other testing methods.

The first part of the test is swallowing radioactive iodine (I-131 or I-123) up to 24 hours before the
test. Then the level of radioactivity in thyroid gland will be measured at certain intervals hours
later using a device called a gamma probe. The probe is placed over the area where the thyroid
gland is located in neck. The original amount of thyroid hormone measured in the blood before the
test is compared to the amount of radioactivity measured after taking the radioactive iodine. This

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

new amount is listed as a percentage of the original amount. It takes about 30 minutes to complete
each scan.

Normal results. The remaining radioactivity is measured as a percentage of the original intake.
The following percentages show the average values according to the time of the test:

6 hours from ingestion: 3% to 16%

24 hours from ingestion: 8% to 25%

Abnormal results. If the results are abnormal, it means the following:

Increased:

• Goiter
• Hyperthyroidism
• Hashimoto’s thyroiditis (early)

If the test taken at 24 hours shows the amount of radioactivity to be greater than 35%, the reading
is considered elevated.

Decreased:

• Sub acute thyroiditis

• Hypothyroidism
• Excessive iodine ingestion

THYROID SCAN AND UPTAKE

A thyroid scan is a diagnostic imaging test that involves injecting a small amount of radioactive
material into the body to visualize the
thyroid gland. Thyroid scan and uptake
uses small amounts of radioactive
materials called radiotracers, a special
camera and a computer to provide
information about thyroid's size, shape,
position and function that is often
unattainable using other imaging
procedures.

A whole-body thyroid scan is typically

performed on people who have or had
thyroid cancer.

A physician may perform these imaging tests to:

• Determine if the gland is working properly

• Help diagnose problems with the thyroid gland, such as an overactive thyroid gland, a
condition called hyperthyroidism, cancer or other growths
• Assess the nature of a nodule discovered in the gland
• Detect areas of abnormality, such as lumps (nodules) or inflammation
• Determine whether thyroid cancer has spread beyond the thyroid gland
• Evaluate changes in the gland following medication use, surgery, radiotherapy or
chemotherapy

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

In general, the scan will take about 40 minutes in total. Patient will need to wait 15–20 minutes
after the injection, and then there will be 15 minutes of scanning time. There are no after effects
of a thyroid scan and you will not feel any different.

The thyroid helps maintain many different functions of the body by processing and adjusting the
levels of certain hormones. A thyroid scan is carried out so doctors can determine which parts of
the thyroid gland are working properly and whether the thyroid gland is overactive
(hyperthyroidism) or underactive (hypothyroidism). It may also help in distinguishing between
benign (non-cancerous) and malignant (cancerous) thyroid nodules. However, it’s important to
note that the specific diagnostic approach for hyperthyroidism can vary, and thyroid scans are just
one component of the diagnostic process.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

VI. MEDICAL OR SURGICAL MANAGEMENT

MEDICAL MANAGEMENT

Medical management of hyperthyroidism often involves antithyroid medications including

1. Prophythioracill (PTU)
2. Methymazole (Tapazole)

THYROIDECTOMY

Thyroidectomy is a surgical procedure that involves the removal of the thyroid gland, a butterfly-
shaped organ located in the front of the neck. The thyroid plays a crucial role in producing
hormones that regulate metabolism, energy levels, and various bodily functions.

There are different types of thyroidectomy procedures:

1. Total Thyroidectomy: Removal of the entire thyroid gland.

2. Subtotal or Partial Thyroidectomy: Removal of a portion of the thyroid gland, leaving
some tissue intact.

Thyroidectomy is a significant intervention with the potential for long-term impact on a patient's
health, and careful consideration is given to its necessity and potential benefits in the context of
hyperthyroidism or other thyroid disorders.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta
Classification and
Name of Drug
Mechanism of Action
Generic Name: Classification:
Prophythiouracil Antithyroid agents
Brand Name: Mechanism of Action:
Propycil Inhibiting the synthesis of
thyroid hormones by
Dosage: 50 mg interfering with the iodination
of tyrosine residues and the
Route: Oral coupling of iodotyrosines in
the thyroid gland. PTU also
Frequency: Q8H inhibits the peripheral
conversion of thyroxine (T4) to
Timing: 8 – 4 - 12 triiodothyronine (T3) outside
the thyroid tissue.
Year & Section: BSN 4 – F
DRUG STUDY
Indication and
Contraindication
Indications:
▪ Patients with Graves’
disease with
hyperthyroidism or toxic
multinodular goiter who are
intolerant to methimazole
and for whom surgery or
radioactive iodine therapy
is not appropriate.
▪ Adjunct in the control of
hyperthyroidism in
preparation for
thyroidectomy or
radioactive iodine therapy
in patients who are
intolerant to methimazole.
Contraindications:
▪ Hypersensitivity to drug
Side Effect or Adverse Nursing
Special Consideration
Effect Responsibilities
Adverse Effect: Use cautiously in: ▪ Check doctors order
CV: edema, vasculitis ▪ Low bone marrow ▪ Observe 10 Rights
reserve; of giving
GI : hepatotoxicity, ▪ OB: May be used medications
nausea, vomiting, during 1st trimester ▪ Monitor for signs of
diarrhea, loss of taste (consider using hypersensitivity
methimazole during reaction to drug
Derm: stevens – 2nd and 3rd ▪ Monitor for signs
johnsons syndrome, trimesters); however, and symptoms of
toxic epidermal fetus may develop drug toxicity
necrolysis, rash, thyroid problems; ▪ PO Administer at
exfoliative dermatitis, mother and fetus may same time in
hair loss, skin be at increase risk for relation to meals
discoloration, urticaria hepatotoxicity; every day. Food
▪ Lactation: Enters may either increase
Endo: hypothyroidism breast milk (safety or decrease
not established); absorption.
GU: ▪ Geri: May have high ▪ Instruct patient to
glomerulonephritis sensitivity; should take medication
initiate therapy with exactly as directed,
Hema: lowest dose; around the clock.
agranulocytosis, ▪ Pedi: Children <6 yr ▪ May cause
aplastic anemia, (safety not drowsiness. Caution
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Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

bleeding, leukopenia, established); not patient to avoid

thrombocytopenia recommended unless driving or other
methimazole not activities requiring
MS: arthralgia, myalgia tolerated and surgery alertness until
or radioactive iodine response to
Neuro: drowsiness, therapy not medication is
headache, paresthesia, appropriate. known.
vertigo

Resp: interstitial
pneumonitis

Misc: fever,
lymphadenopathy,
parotitis, splenomegaly

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta
Classification and
Name of Drug
Mechanism of Action
Generic Name: Classification:
Methimazole Antithyroid agents
Brand Name: Mechanism of Action:
Tapazole Inhibits the synthesis of thyroid
hormones by blocking the
Dosage: 15 mg activity of an enzyme called
thyroperoxidase. This enzyme
Route: Oral is crucial for the iodination of
tyrosine residues and the
Frequency: Q8H coupling of iodotyrosines,
steps involved in the
Timing: 8 – 4 - 12 production of thyroid
hormones (T3 and T4). By
interfering with these
processes, methimazole helps
reduce the levels of thyroid
hormones in the body,
effectively treating
hyperthyroid conditions.
Year & Section: BSN 4 – F
Indication and
Contraindication
Indications:
▪ Palliative treatment of
hyperthyroidism.
▪ Used as an adjunct to
control hyperthyroidism in
preparation for
thyroidectomy or
radioactive iodine therapy
Contraindications:
▪ Hypersensitivity to drug
Side Effect or Adverse Nursing
Special Consideration
Effect Responsibilities
Adverse Effect: Use cautiously in: ▪ Check doctors order
Derm: rash, skin ▪ Patients with low ▪ Observe 10 Rights
discoloration, urticaria bone marrow reserve; of giving
▪ Patients >40 yr (high medications
GI: diarrhea, risk of ▪ Monitor for signs of
hepatotoxicity, loss of agranulocytosis); hypersensitivity
taste, nausea, parotitis, ▪ OB: Use during reaction to drug
vomiting pregnancy only if ▪ Monitor for signs
potential maternal and symptoms of
Hemat: benefit justifies drug toxicity
agranulocytosis, potential fetal risk. ▪ Monitor vital signs
anemia, leukopenia, May cause congenital ▪ Instruct the patient
thrombocytopenia malformations to promptly report
(especially if used any unusual
MS: arthralgia during 1st trimester). symptoms.
▪ Monitor liver
Neuro: drowsiness, function regularly
headache, vertigo due to the rare risk
of methimazole
Misc: fever, causing liver
lymphadenopathy dysfunction
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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

Classification and Indication and Side Effect or Adverse Nursing

Name of Drug Special Consideration
Mechanism of Action Contraindication Effect Responsibilities

Generic Name: Classification: Indications: Adverse Effect: Use cautiously in: ▪ Check doctors order
Propanolol Beta-adrenergic receptor Used to treat conditions such as ▪ Fatigue or ▪ Asthma or other ▪ Observe 10 Rights
antagonist high blood pressure, angina weakness respiratory conditions of giving
Brand Name: (chest pain), irregular ▪ Cold extremities ▪ Diabetes, as it may medications
Hemangeol Mechanism of Action: heartbeats (arrhythmias), and to (hands and feet) mask hypoglycemic ▪ Assess vital signs,
A nonselective β-adrenergic prevent migraines ▪ Bradycardia (slow symptoms including blood
Dosage: 20 mg receptor antagonist. Blocking heart rate) ▪ Heart failure or pressure and heart
of these receptors leads to Contraindications: ▪ Hypotension (low certain heart rhythm rate
Route: Oral vasoconstriction, inhibition of ▪ Hypersensitivity to drug blood pressure) disorders ▪ Monitor for signs of
angiogenic factors like ▪ Asthma ▪ Dizziness or ▪ Peripheral vascular hypersensitivity
Frequency: Q12H vascular endothelial growth ▪ Certain heart conditions lightheadedness disease reaction to drug
factor (VEGF) and basic ▪ Slow heart rate ▪ Gastrointestinal ▪ Thyroid disorders ▪ Monitor for signs
Timing: 8 am – 8 growth factor of fibroblasts (bradycardia) disturbances ▪ Liver or kidney and symptoms of
pm (bFGF), induction of apoptosis ▪ History of severe allergic (nausea, vomiting, impairment drug toxicity
of endothelial cells, as well as reactions diarrhea) ▪ History of severe ▪ Observe for signs of
down regulation of the renin- ▪ Sleep disturbances allergic reactions adverse effects, such
angiotensin-aldosterone ▪ Depression or vivid ▪ Elderly individuals, as dizziness or
system. dreams as they may be more respiratory distress
▪ Masking of sensitive to its effects
hypoglycemia
symptoms in
diabetic patients

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta
DEFINING NURSING DIAGNOSIS
CHARACTERISTICS
Subjecstive: Imbalanced Nutrition: Less
Than Body Requirements
“Nagabuhin bala akon kilo related to increased
bisan nagakaon ko sang metabolic rate and
damo doc” as verbalized hyperthyroidism as
by the patient. evidence by weight loss of
10 lbs last week, muscle
weakness, dry and brittle
hair and nails, fine tremors
Objective: in hands.
Temp.: 37° C
PR: 110 bpm
Rationale:
RR: 18 bpm
This diagnosis lies in the
impact of hyperthyroidism
Blood Pressure: 130/80
on the bodys energy
Oxygen Saturation: 98% expenditure and the
subsequent inadequacy of
Year & Section: BSN 4 – F
NURSING CARE PLAN
OUTCOME NURSING RATIONALE EVALUATION
IDENTIFICATION INTERVENTIONS
Long Term: Independent: Goals was partially met as
the patient is continuously
Within 2 weeks of nursing Regulary monitor vital Frequent monitoring of monitored but patient has
interventions, the patient signs vital signs aids in gained weight in desired
progressively gain weight identifying any signs of goal and consumed
toward desired goal and worsening hyperthyroidism adequate nourishment that
maintain a weight within or potential complications, lessen the aggregating
the normal range for age guiding prompt signs of hyperthyroidism
and height. intervention. such as weight loss of 10
lbs last week, muscle
Short Term: weakness, dry and brittle
Monitor and record dietary
intake Tracking the patient’s food hair and nails, fine tremors
After 24 hours of nursing
intake helps identify in hands.
interventions, the patient
nutritional deficiencies and
will consume adequate
patterns contributing to
nourishment and consume
weight loss, allowing for
a nutrient-dense diet, as
targeted interventions.
guided by the dietitian.
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Weight : 55 kg.
Fatigue
Pallor
Diminished bowel sounds
Muscle weakness
Fine tremors in hands
Dry, brittle hair and nails
Weight loss of 5 pounds in
the last 2 week
Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F
caloric intake. Intake of Hyperthyroidism increases
nutrients insufficient to Encourage high-calorie, metabolic rate, requiring
meet metabolic needs. nutrient-dense diet additional calories.
Promoting nutrient-dense
References: foods supports weight gain
and addresses nutritional
Doenges, M. E., deficits.
Moorhouse, M. F., & Murr,
A. C. (2022, October 19).
Nurse’s Pocket Guide:
Provide small, frequent Offering smaller, more
Diagnoses, Prioritized frequent meals helps
meals
Interventions, and combat muscle weakness
Rationale 10th Editions and fatigue associated with
(Nurse’s Pocket Guide: hyperthyroidism, ensuring
Diagnoses, Interventions & a steady energy supply.
Rationales) (10th ed.). F A
Davis Co.
Addressing any difficulties
Assess swallowing and with swallowing or
chewing ability chewing can enhance the
patient’s ability to consume
and absorb nutrients
Note: Nursing Diagnosis effectively.
should be base from
(NANDA- Approved Rest is crucial for energy
Facilitate rest and
Nursing Diagnosis) conservation and muscle
relaxation
recovery. Assisting the
patient in creating a
conducive environment for
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Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

rest can mitigate symptoms

of fatigue and weakness.

Educate on importance of
adequate fluid intake Hyperthyroidism can lead
to increased fluid loss.
Educating the patient on
the importance of adequate
hydration helps prevent
Dependent: dehydration and supports
overall well-being.
Administer medications as
prescribed. The following
medications are used: Administration of
prescribed medication is to
alleviate discomfort and
promote optimal
respiratory effort.
Prophythiouracil 50 mg
Q8H
Prophythiouracil and
Methimazole 15 mg Q8H Methimazole are
medications used to treat
hyperthyroidism by
inhibiting the production of
thyroid hormones.
Propanolol 20 mg Q12H
Propranolol is a beta-
blocker that helps manage
symptoms of

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Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

hyperthyroidism, such as
rapid heart rate and
tremors.

Collaborative:

Collaborate with Dietitian

Involving a dietitian allows
for personalized dietary
planning, ensuring the
patient receives adequate
nutrients and energy to
meet increased metabolic
demands.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

VIII. NURSING MANAGEMENT/NURSING CONSIDERATIONS

Medications:

- Administer the prescribed antithyroid medications, such as methimazole or propylthiouracil, to

hinder the synthesis of thyroid hormones.

- Keep a vigilant eye for any adverse reactions, like rashes or agranulocytosis.

- Provide beta-blockers like propranolol to address symptoms such as tachycardia and tremors,
while closely monitoring blood pressure and heart rate.

- Follow established protocols when administering iodine preparations, like potassium iodide, to
mitigate the release of thyroid hormones and watch for signs of iodine toxicity.

Diet:

- Encourage the patient to maintain a well-balanced, high-calorie diet to counteract the heightened
metabolic rate associated with hyperthyroidism.

- Recommend frequent, small meals to sustain energy levels.

- Stress the importance of increased fluid intake to prevent dehydration linked to elevated
metabolic activity, with careful monitoring for signs of fluid overload, especially in patients with
cardiovascular concerns.

Activities of Daily Living (ADL):

- Advise the patient to prioritize and plan activities to conserve energy, incorporating scheduled
rest periods to prevent fatigue.

- Monitor for signs of hyperthermia resulting from increased metabolic activity and implement
measures to ensure a comfortable environment, including cooling strategies as needed.

Health Teachings:

- Emphasize the critical role of consistent adherence to prescribed medications, providing

education on potential side effects and stressing the need for regular follow-ups.

- Instruct the patient to monitor and promptly report symptoms such as palpitations, weight loss,
and anxiety.

- Encourage the limitation or avoidance of iodine-rich foods to prevent exacerbation of

hyperthyroidism.

- Provide stress-reduction techniques, including relaxation exercises and activities, to manage

stress which can exacerbate symptoms.

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 Related Learning Experience (Hyperthyroidism)
Name: Jecelle De la Puerta Year & Section: BSN 4 – F

IX. REFERENCES

Acr, R. A. (2023, May 1). Thyroid scan and uptake. Radiologyinfo.org.

https://www.radiologyinfo.org/en/info/thyroiduptake?google=amp

Facts about Hyperthyroidism. (2021, May 28). National Nutrition Council. Retrieved November
28, 2023, from https://www.nnc.gov.ph/regional-offices/mindanao/region-ix-zamboanga-
peninsula/5330-facts-about-hyperthyroidism

Hyperthyroidism (Overactive thyroid). (2022, November 16). National Institute of Diabetes and
Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/endocrine-
diseases/hyperthyroidism

Reid, J. R. (2005, August 15). Hyperthyroidism: diagnosis and treatment. AAFP.

https://www.aafp.org/pubs/afp/issues/2005/0815/p623.html

Radioactive iodine uptake: MedlinePlus Medical Encyclopedia. (n.d.).

https://medlineplus.gov/ency/article/003689.htm

Hollingsworth, H. (2021, December 9). What is a radioactive iodine uptake test? WebMD.
https://www.webmd.com/a-to-z-guides/what-is-radioactive-iodine-uptake-
test#:~:text=An%20RAIU%20is%20a%20nuclear,diagnostic%20tools%2C%20including
%20exploratory%20surgery.

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