HYPO &HYPER THYRODISM
PREPARING BY :-
ASHRAF IBRAHIM

DEFINATION
Hypothyrodism :-
It is condition charqtrised in sufficient release of
thyroid hormone due to problem in the
hypothalamus pituitary gland or thyroid gland it self
result in slowing of all body process.

Type of hypothyroidism
 Primary hypothyroidism:-
due to ds function of thyroid gland it self.
 secondary hypothyroidism :-
due to disorder of pituitary gland also caused by
peripheral persistence to thyroid hormone .
 Tertiary hypothyroidism:-
Due to failure of hypothalamus to produce T.R.H

RISK FACTOR
Endemic gaiter occur in client living area that are
iodine deficient in social and water.

CAUSES
 Congenital defect of the thyroid (cretinism).
 Defective hormone synthesis .
 Iodine deficiency (prenatal –postnatal).
 Anti thyroid drugs .
 Surgery and radiation therapy .
 Chronic inflammatory daises of thyroid gland.

Sing and Symptom
 As metabolic slow the pt may experience weakness
sleepiness , fatigue,slowness of speech and though
feeling of cold , constipation ,slight to moderate
weight gain ,oedema of larynx and medial ear may
cause voice change (horsiness) .
 Hearing loss (in sever cases).
 Dry skin and coarse hair .
 Puffy eye lids face and hand and swollen leg
 In sever hypothyroidism un treated myxedema coma
may occur.

Diagnosis test
 Thyroid function test .in primary thyrodism
 Blood test (T.R.H, T.S.H, ).
 T3, T4.check decrease.

MEDICAL MANGEMENT
 Synsithic thyroxin .
 Other type of management supportive therapy.

Complacation
 Hyperthyrdism
 comamyxedema
 In sever hypothyroidism and myxedema coma
management include maintaining the vital function
(ABG)should be measure to determine use of
assisted ventilation to compact hypoventilation.

Complacation
 Pulse ox meter help full monitoring oxygen
saturation level.
 Effects of thyroid hormone may be increase by try
cyclic anti depressant .
 Thyroid hormone may increase pharmacological
effect of digitalis –anti coagulant and end mechanic.

Nursing diagnosis
 Activity intolerance related to fatigue and
depressant
Goal :- to increase participation in activity
Implementation :-
I. Promote independent in self car activity.
II. Space activities to promote rest and exercise as
tolerated.

Nursing diagnosis
I. Provide stimulation through alter thought
process conversation and non stress full
activities.
II. Monitor pt response to increase activity.

 Constipation related to deprest GIT function
GOAL :- return to normal bowel function
implementation :-
 engorge fluied intake with in limits of fluid
Restruction.
 Provied food high in fibres.
 instruct pt about food with high water content
monitoring bowel function.

 encourage mobility with in pt exercise to clearance.
 engorge pt to use laxative medication as needed.
 Hypothermia related to slowed metabolic rate.
goal :- client will maintain normal body temperature.
implementation :-
 Provide extra layer of clothes or extra blanket
 Avoid use of external heat sources e.g. Electric
 Monitor pt body temperature and report.

 Knowledge deficit about therapeutic regimen for life
long thyroid replacement therapy.
Goal :- knowledge and acceptance of the prescribe
therapeutic regimen.
Implementation:-
 Explain for thyroid hormone replacement.
 Describe effect of medication to the pt.
 Explain the necessary for long term fallowup
To pt and family.

 Risk for complication( collaprotive problem) e.g.
Maxyedema coma .
Goal :- present of complication
 Monitoring pt for increasing severity of sign and
symptom of hypothyroidism and avoid use of hypnotic
selective and analgesic agent.
 Support if their is respiratory depression and failure.
 Turn and re position pt at intervals.

Hyperthyrodism

DEFINATION
hyperthyroidism :-
It’s the condition represent the physiological
response of the body to an excessive function
activity of the thyroid gland.

Pathophysiology
Hyperthyroidism is characterized by lose of normal
regulatory control thyroid hormone secretion.
Hyper metabolism result with increase thempathatic
(nerves system activity).

causes
Thyroiditis :- inflammation of thyroid gland
abnormal stimulation of the thyroid gland by
circulation immunoglobulin .
the exact case is unknown but recently it though
to be associated with thyroid stimulated
immunoglobulin.
 it may appear after and emotional shock stress
or an infection.

causes
 though come case including thyroids and
excessive in digitations of thyroid hormone.
Graves’ Disease: stimulating autoantibodies.

Sing &Symptom
 Sweating and heat intolerance.
 Weight loss inspect increase appetite.
 Hart rate increase signs tachycardia.
 Loss stool or diarrhoea are common.
 Skin is warm and mist fine silky hair.
 CNS :- nervousness , restlessness.

Sing &Symptom
 Pt insomnia.
 Goiter.
 Menstrual irregularities.
 Pt exophthalmoses (bleeding eyes)& pain or
diplopia.

diagnosis
Radio active iodine up take scan.
Blood stimation of hormane.
ECG.

Complication
 Hypothyroidism.
 Tachycardia more than 130.
 Temperature 38.5 above.
 Disturbance of major system :-
GIT system(weight loss and diarrhoea)
Neorgical system coma.
Cardio vascular system.
Oedema , chest pain, dyspnoea and palpitation.

Medical mangement
 Anti thyroid drugs drug e.g. Methimalol.
 Irradiation iodine.
 Removal of mast of thyroids (thyroid resection).

Nursing diagnosis
1- Alter nutrition less tan body require mint R/T
execrated metabolic rate excessive appetite
increase GIT activity.
Goal :- improve nutritional status
Implementation :-
 Pt apetite may be satisfied by several well balance
meal of smal size.
 Food and fluid are selected to replase fluied
 Loss though dirrhea .

Nursing diagnosis
 Reduce coffe cola and stop alcoholic colorie.
 And high protein food are engorge.
 PT weight and dietary intake record to monetar
nutrition statis.

Nursing diagnosis
2- in effective coping R/t Irritability and emotion
instability.
GOAL :- improve coping abilites
Implementation :- the pt need reasurence
Amotion reaction are result of disorder and
With effective treatment thoesymption will be
control.

Nursing diagnosis
 Family and friend needle re assurance that
symptom are expected to dis appear with
treatment.
 It is important to ves calm unhurried approach
with PT.
 Stress ful experience are minimise the PT lsnet
placed in room with very ill with to cative PT if
hostitalive.
 Relax activity are engorge.

Nursing diagnosis
3/ Alter body temp related to sweating.
Goal :- to maintain normal body temp
Implementation :-
The environment should be maintained at cool
Comfortable and closing should be change as
needed.

Difference Between Hypo & Hyper thyroidism
hypothyroidism
 Fatigue.
 Feeling cold.
 Rapid weight gain.
 Slow heart rate.
 Slow Decreased.
Sweating.
 Constipation.
 depression, moodiness.
hyperthyroidism
 Fatigue.
 Feeling hot.
 Rapid weight loss.
 Increased or irregular heart
rate.
 Excessive sweating.
 Diarrhea.
 Anxiety, nervousness.

Difference Between Hypo & Hyper thyroidism
hypothyroidism
 low blood pressure.
 Dry skin and hair.
 increased menstrual
flow.
 Facial swelling or
other swelling.
hyperthyroidism
 high blood pressure.
 skin thinning.
 lack of menstrual period.
 Insomnia.

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