CHAPTER 8 Endocrine System^335
- Serum measurements of T3 and T4 will need to be performed after 6 to 8
weeks to determine if the patient is taking the correct dose. - The patient needs to be aware that this is a lifetime replacement.
NURSING DIAGNOSES
- Risk for imbalanced nutrition: more than what body requires
- Hypothermia related to decreased metabolic rate
- Risk for constipation related to decreased motility of the GI tract
NURSING INTERVENTION
- Monitor vital signs.
- Provide a warm environment.
- Low-calorie diet.
- Increase fluids and fiber to prevent constipation.
- Take thyroid replacement hormone each morning to avoid insomnia.
- Monitor for signs of thyrotoxcosis (an increase in T3): nausea, vomiting,
diarrhea, sweating, tachycardia. - Explain to the patient:
- Side effects of thyroid hormone replacement.
- Review the signs of hyperthyroidism and hypothyroidism.
- Have patient contact health care provider if signs change.
Hyperthyroidism (Graves’ Disease)
WHAT WENT WRONG?
There is an overproduction of T3 and T4 by the thyroid gland that can be caused by
an autoimmune disease where the body’s immune system attacks the thyroid gland.
Other causes can be a benign tumor (adenomas) resulting in an enlarged thyroid
gland (goiter) or an overproduction of TSH by the pituitary gland, caused by a pitu-
itary tumor.
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