A patient is being admitted to the unit from the emergency department. The nurse calls in the report on the patient to the receiving nurse and conveys the assessment findings:
complaints of restlessness, agitation, and tremor; vital signs are temperature of 105° F, pulse 122, blood pressure of 90/47, and respiration of 28. The nurse suspects that the patient is showing signs and symptoms of ___________ and anticipates the administration of multiple drugs, including ______________ to suppress thyroid hormone release.
a. thyroid storm; potassium iodide or a strong iodine solution
b. toxic nodular goiter; a beta blocker
c. Hashimoto's thyroiditis; propylthiouracil
d. thyrotoxic crisis; propylthiouracil
ANS: A
The signs and symptoms displayed are consistent with thyroid storm, also known as thyrotoxic crisis. The medication used to suppress thyroid hormone release is potassium iodide or a strong iodine solution.
Toxic nodular goiter is similar to Graves' disease in signs and symptoms except for the absence of exophthalmos; the beta blocker might be given to reduce the heart rate and the tremors which are common with hyperthyroidism.
Hashimoto's thyroiditis is a chronic autoimmune disease that is a type of hypothyroidism.
Thyrotoxic crisis is not synonymous with hyperthyroidism and is managed differently, depending on its etiology. Propylthiouracil is used to suppress thyroid hormone synthesis and peripheral conversion of T4 to T3.
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