The nurse is reviewing orders for a patient in myxedema coma. Which orders should the nurse question before administering to this patient?
Select all that apply.
1. regular insulin IV at 5 units per hour
2. cooling blanket
3. methimazole (Tapazole) 15 mg PO daily
4. pulse oximetry and vital signs hourly
5. serum TSH level daily
Correct Answer: 1,2,3
Myxedema coma is characterized by hypoglycemia. There is no evidence that IV insulin is indicated for this patient, and administering it would likely be harmful to an already hypoglycemic patient. Patients with myxedema are often hypothermic, and a cooling blanket would also be harmful. Methimazole (Tapazole) interferes with thyroid hormone and would be contraindicated for a patient in myxedema coma. Hourly vital signs with oximetry and daily serum TSH monitoring are appropriate for this patient.
You might also like to view...
A nurse notes a patient has abnormal vital signs. What action by the nurse is best?
a. Document the findings. b. Notify the provider. c. Compare with prior readings. d. Retake the vital signs.
The nurse manager of an ambulatory care center assesses the center for environmental hazards to comply with guidelines of both the local state health department and the
a. Ambulatory Care Nursing Administration and Practice. b. American Nurse's Credentialing Center. c. Nurse Practice Act. d. Occupational Safety and Health Administration.
The nurse is caring for a 21-year-old female burn victim. Her parents ask why their daughter has to be fed by a nasogastric tube (NG). What would be the best response?
A) "Your daughter's intestines are not working normally right now so we have to feed her through a tube." B) "If your daughter were eating normally, she would get sicker because her intestines are not working right." C) "We need to get a lot of calories and nutrients into your daughter to help her heal, and this is the best way to do that." D) "Trying to eat normally would just wear your daughter out, so we feed her through a tube to conserve her energy."
A nurse is explaining to a woman about the advantages and disadvantages of using an intrauterine device. Which of the following is a disadvantage of intrauterine devices?
1. Expensiveness of the device 2. Increased bleeding during menses 3. Continuous contraceptive protection 4. Non–coitus-related activity