Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous coma? Select all that apply
A)
Administer 3% sodium IV solution to increase sodium levels.
B)
Administer 50% dextrose to raise glucose levels.
C)
Place on oxygen therapy to encourage deep breathing.
D)
Place on a warming bed to raise body temperature.
E)
Administer sedatives frequently to prevent seizures.
Ans:
A, B, C
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Myxedematous coma is a life-threatening, end-stage expression of hypothyroidism. It is characterized by coma, hypothermia, CV collapse, hypoventilation, and severe metabolic disorders that include low sodium, low glucose, and lactic acidosis. Treatment includes aggressive management of precipitating factors; supportive therapy such as management of CV status, hyponatremia, and hypoglycemia; and thyroid replacement therapy. If hypothermia is present, active rewarming is contraindicated because it may induce vasodilation and vascular collapse. Administering sedatives frequently could be harmful since the person is unable to metabolize sedatives, analgesics, and anesthetic drugs.
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