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