The nurse is caring for a patient 6 hours after a thyroidectomy and notes the patient's temperature is 104°F, pulse is 144 beats per minute, respirations are 24 per minute, and blood pressure is 184/108 mm Hg
Which of the following orders does the nurse anticipate?
a. Beta blockers and a cooling blanket
b. Epinephrine and compression dressings
c. Aspirin and bedrest
d. Diphenhydramine (Benadryl) and Fowler's position
ANS: A
If thyrotoxic crisis occurs, treatment is first directed toward relieving the life-threatening symptoms. Acetaminophen is given for the fever. Aspirin is avoided because it binds with the same serum protein as T4, freeing additional T4 into the circulation. Intravenous fluids and a cooling blanket may be ordered to cool the patient. A beta-adrenergic blocker, such as propranolol, is given for tachycardia. Epinephrine will make symptoms worse. Compression dressing on the thyroid could impair the airway. Benedryl and Fowler's position do not address the problem.
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