Hyperthyroidism & Thyroid Storm (Thyrotoxicosis) – Med-Surg (2020 Edition) – Endocrine | Level Up RN

Alright. In this video, we are going to talk abouthyperthyroidism as well as thyrotoxicosis. If you are following along with posters, I’mon poster 37. So with hyperthyroidism, we have excess secretionof T3 and T4 from the thyroid gland, and just like we attended with hypothyroidism, we have primary, secondary, and tertiary causes of this ill. And if you echo, the hypothalamus producesTRH, thyroid-releasing hormone which causes the pituitary gland to produce TSH, thyroid-stimulatinghormone and that allows for secretion of T3 and T4 from the thyroid gland. So if we have an issue with the thyroid glanditself – so that would be primary hyperthyroidism – the most common cause is Grave’s Diseasewhich is an autoimmune issue, but we can also have some kind of thyroid nodule. Due to one of these generates, “were having” hypersecretionof T3 and T4. So that’s primary hyperthyroidism. With secondary hyperthyroidism, this is wherewe have some kind of pituitary disorder such as a tumor, which is causing excess secretionof TSH. So with all this additional TSH, the thyroid glandis getting the content to produce more and more thyroid gland hormones even though itdoesn’t really need to, but that’s the degree it’s getting from the pituitary gland.And then with tertiary hyperthyroidism, thatmeans we have an issue in the hypothalamus. So due to some kind of hypothalamus dysfunction, the hypothalamus is raising too much TRH, which is causing the production of too muchTSH, which is causing the thyroid gland to go into overdrive, producing all that T3 andT4 even though it really isn’t supposed to only because it’s getting that seek fromabove. So those are the three causes of hyperthyroidism. So with all that T3 and T4 being producedby the thyroid gland, it genuinely leans the body into a hypermetabolic regime. So signals and symptoms of hyperthyroidism includetachycardia, hypertension, heat intolerance, projection eyeballs, which is something calledexophthalmos, weight loss without trying, insomnia, diarrhea, and warm, sweaty scalp. In calls of the labs we’ll attend with hyperthyroidism, T3 and T4 heights will be elevated. TSH heights will depend on whether we’re talkingabout primary or secondary hyperthyroidism. So with primary hyperthyroidism, that’s wherewe have Life-and-deaths’ malady or a thyroid nodule, that thyroid gland is just cranking out theT3 and T4 regardless of how much TSH it’s getting.The pituitary gland’s over here really concerned, like, “Wow, you’re putting out a lot of T3 and T4. Can you delight chill out? ” And the thyroid gland’s like, “I can’t chillout. I got to keep spawning my T3 and T4. ” So the pituitary gland is scaling back howmuch TSH it applies the thyroid gland, but the thyroid gland doesn’t care. Doesn’t care and is going to keep crankingthat nonsense out as fast as it can.So with primary hyperthyroidism, elevatedT3 and T4 but abridged TSH because that pituitary gland is trying to rein that thyroid glandin. When we have secondary or tertiary hyperthyroidism, then our levels of TSH will be increased, right, because there’s some kind of tumoror failure which is causing increased TSH, which is causing the thyroid gland toproduce more T3 and T4. So the thyroid gland is functioning fine. He’s like, “I envision I’m making enough T3, T4 here. ” But the pituitary gland’s going crazy andis like, “No. Here’s some more TSH. Make more. Make more.” And the thyroid gland’s like, “Okay, I’lldo that.” And that’s secondary hyperthyroidism. So with that, we’ll have hoisted TSH andelevated T3 and T4. Alright. Let’s move to treatment. So if a patient has primary hyperthyroidism, they may need a thyroidectomy, which is removal of the thyroid gland. And in my next video, we will talk about nursingcare of patients who have to undergo a thyroidectomy.Medications that could be used include PTU, iodine answers, as well as beta-blockers to help bring those vital signs down. In calls of harbouring charge, we’re going to wantto increase our patient’s calorie and protein intake because of that weight loss and thefact that they’re in this hypermetabolic state. We’re going to want to monitor their I’s andO’s as well as their force and their vital signs. And then for exophthalmos, which is the bulgingeyes, we’re going to want to tape their eyelids closed for sleep and specify see lubricantto really protect persons attentions. Alright. So let’s briefly talk about a life-threateningcomplication of hyperthyroidism which is thyrotoxicosis, or a thyroid rain. This is where we have excessively high levelsof thyroid hormones. And this could be brought on due to infection, stress, diabetic ketoacidosis, which is DKA, or maybe due to a thyroidectomy. In calls of signeds and evidences of this ailment, we’re going to have severe hypertension as well as chest pain, dysrhythmias, dyspnea, which is difficulty breathing, delirium, fever, and nausea and vomiting.So in terms of treatment, we can give thispatient beta-blockers to try to get those vital signs in control, antithyroid prescriptions, as well as antipyretics for treating the excitement. And in terms of nursing care, we’re definitelygoing to want to maintain a patent airway, which is always your number-one priority, and then likewise check individual patients for dysrhythmias. So that is it for hyperthyroidism.In my next video, we will talk about careof a patient who requires a thyroidectomy. Thanks so much better for watching !.