Graves' Disease

1. Anatomy and physiology of the thyroid gland.

1. The thyroid gland is located beside the windpipe just below the voice box.

2. The gland secretes hormones, which control the rate of metabolism.

3. Iodine in the diet is required for production of thyroxin, a primary hormone produced by the thyroid gland.

2. Definition of "Graves' Disease."

1. It is the most common form of hyperthyroidism.

2. Hyperthyroidism occurs when the thyroid gland produces an excess of thyroid hormones.

3. Excess thyroid hormones cause an increased rate at which the body uses energy.

3. Signs and symptoms of Graves' Disease.

1. Increased appetite and weight loss.

2. Increased restlessness and nervousness.

3. Fatigue and weakness.

4. Heat intolerance.

5. Fast heart rate.

6. Loose bowel movements.

7. Heavy perspiration.

8. Enlarged goiter.

9. Emotional instability.

10. Exophthalmos (eyeball protrudes from the orbit).

4. Measures to alleviate symptoms.

1. Symptom: Restlessness

Measures:

1. Avoid emotional or physical stimulation until metabolism returns to normal.

2. Provide restful environment and plan quiet activities.

3. Avoid caffeine, yellow and red food dyes, and artificial preservatives (they increase irritability).

4. Avoid aspirin and aspirin products, which increase metabolic rate.

2. Symptom: Weight loss

Measures:

1. Eat a well-balanced, high calorie diet.(Provide "Daily Food Guide" and "Increase Calories" handouts.)

2. Weigh daily.

3. Symptom: Loose bowel movements.

Measures:

1. Avoid highly seasoned foods and foods that are high in bulk or fiber.

2. Increase fluids to prevent dehydration.

4. Symptom: Eyeball protrusion and eye irritation.

Measures:

1. Apply cool, moist compresses.

2. Shield eyes with eye patches or sunglasses.

3. Cover or tape eyelids shut at night.

4. Sleep with head of bed elevated.

5. Limit fluids and sodium to decrease fluid retention in eyeballs. (Provide "Restrict Sodium" handout.)

5. Symptom: Heat intolerance and heavy perspiration

Measures:

1. Provide cool environment.

2. Encourage good hygiene.

6. Symptoms: Depression

Measures:

1. Obtain emotional support or counseling as needed.

2. Dress attractively to increase self-esteem.

5. Possible medical interventions.

1. Antithyroid medication.

2. Radioactive iodine.

3. Surgery.

6. Signs and symptoms of possible complications.

1. Heart disease (chest pain, edema, shortness of breath, etc.).

2. Hypothyroidism (lethargy, fatigue, forgetfulness, weight gain, etc.).

3. Thyroid storm (high fever, very rapid heart rate, delirium, dehydration, extreme irritability).