Thyroid Storm NCLEX Review
Thyroid storm NCLEX review notes for students who are prepping to
take the NCLEX exam. The endocrine system is made-up of many
disorders, such as thyroid storm which is a complication of untreated
hyperthyroidism. This NCLEX review is part of an endocrine series of
thyroid disorders.
As a student prepping for NCLEX, it is very important you know the
details of thyroid storm and how to care for a patient experiencing this
condition.
As the nurse taking care of the patient in thyroid storm it is important
you understand the signs and symptoms, pathophysiology, causes,
nursing interventions, and medical treatments.
Don’t forget to take the quiz on thyroid storm.
In this NCLEX review, you will learn the following:
-Pathophysiology of the thyroid storm
-Signs and symptoms of thyroid storm
-Causes of thyroid storm
-Nursing Interventions
-Medications for thyroid storm
-Treatments
Lecture on Thyroid Storm
:
Thyroid Storm
Definition: Life-threatening complication that develops in someone
who has hyperthyroidism which is an excessive secretion of thyroid
hormones (T3 and T4).
It is usually because hyperthyroidism is not being treated properly, the
patient is undiagnosed, or the patient experienced an illness.
In addition, thyroid storm can develop after a thyroidectomy due to the
thyroid being manipulated during removal which can cause high
amounts of T3 and T4 to enter into the blood stream. However, it is rare
because today patients are placed on medications to help combat this.
Causes of Thyroid Storm
Patients will already have hyperthyroidism along with any of the
following:
got an illness or experienced trauma/stress (septic, DKA, surgery,
trauma to the gland)
suffers from Grave’s Disease that is under treated or they became
:
sick
not taking antithyroid medications properly
taking medications that increase thyroid hormones (Salicylates:
ASA)
pregnancy
radioactive iodine therapy (CT scan or as treatment) remember the
thyroid loves iodine and uses it to make thyroid hormone
Signs & Symptoms of Thyroid Storm
The patient will have typical hyperthyroidism symptoms but they will be
SEVERE to the point of death…remember the function of T3 and T4 is
to increase body’s metabolism and temperature and to stimulate the
sympathetic nervous system (this will be happening at an accelerated
rate).
Remember this condition as: A violent storm on the body at an
accelerated rate.
Fever (not just heat intolerance)
Hypertension—going to exhaust the heart to the point of failure
(CHF or MI)
Tachycardia— going to exhaust the heart to the point of failure
(CHF or MI)
Increase respirations—due to the body working so hard and it
needs more oxygen and nutrients…will get respiratory failure if not
treated fast
Very restless, irritable, confused …this will progress to seizures,
delirium, coma
Diarrhea
:
Nursing Interventions for Thyroid Storm
Monitor HR, BP, RR (respiratory failure…may need mechanical
ventilation), EKG, Temperature
Keep environment quiet and patient cool (cooling blankets and
sedatives as prescribed)
No foods containing iodine (seafood…seaweed, dairy, eggs)
Pharmacological Management of Thyroid Storm
Goals:
1. Need to decrease the thyroid hormone:
Antithyroid medications (block synthesis) :
Tapazole “Methimazole”: has fewer side effects than PTU…
not for first trimester of pregnancy
PTU “Propylthiouracil”: can be used during 1st trimester…
watch for liver failure
Side Effects with these medications: Agranulocytosis and
thrombocytopenia and watch for toxicity which will present as signs
and symptoms of HYPOTHYROIDISM: slow heart rate, intolerance to
cold, drowsy
Iodide solution (block secretion)
Lugol’s solution: Side effects: taste changes metal taste in
mouth
2. Decrease fever:
Tylenol NO Salicylates or cooling blankets
:
3. Decrease effects of thyroid hormones on the body by blocking
peripheral conversion of T3 and T4:
Beta Blockers: Inderal (not for people with asthma or history of
bronchospasm…watch in diabetics can mask hypoglycemia)
4. Prevent further secretion and conversion of thyroid hormones
by suppressing immune system with:
Glucocorticoids (Dexamethasone )
You may be interested in: Diabetes NCLEX Reviews
:
