A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patient's vital signs: T 103 ° F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have?
a. Pulmonary embolism
b. Hypertensive crisis
c. Thyroid storm
d. Cushing crisis
ANS: C
In a thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. Additionally, the patient may develop nausea, vomiting, severe tachycardia, severe hypertension, and occasionally hyperthermia up to 41 ° C (106 ° F). Extreme restlessness, cardiac arrhythmia, and delirium may also occur. The patient may develop heart failure and may die.
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