THYROTOXICOSIS

Question 1

what is a thyroid storm?

Answer 1

sudden surge of large amounts of thyroid hormones which cause increase in body metabolism.

Question 2

what are clinical manifestations of thyrotoxicosis?

Answer 2

1. hyperthermia
2. hypertension
3. fever that is 104-105
4. delirium and seizures
5. fast dysrhythmias/chest pain/palpitations

Question 3

what are lab findings for a patient with a thyroid storm?

Answer 3

T3 and T4 are elevated

Question 4

what are priority interventions for a patient with a thyroid storm?

Answer 4

1. maintain airway
2. initiate continuous cardiac monitoring
3. monitor I&Os hourly
4. cool patients with a sponge bath or ice packs to help with the hyperthermia
5. IV fluids are given to prevent vascular collapse due to the fluid volume deficit

Question 5

what medications can be given for a thyroid storm?

Answer 5

1. acetaminophen for fever
2. propylthiouracil and methimazole to stop excess production of thyroid hormones
3. propranolol to control HR and BP
4. glucocorticoids for adrenal insufficiency or shock
5. no aspirin can be given because it increases thyroxine levels

Question 6

what are complications of a thyroid storm?

Answer 6

1. restlesness that looks like impending sense of doom, stroke , MI
2. thyroidectomy complications
3. hypocalcemia
4. heart failure

Question 7

what are thyroidectomy complications?

Answer 7

airway obstruction, laryngeal edema, stridor, hemorrhage, and tracheal collapse

Question 8

what are signs of hypocalcemia and what is the antidote?

Answer 8

1. tingling of fingers, muscle twitching, Chvostek’s and Trousseaus, seizures
2. give calcium gluconate as antidote