A client with poorly controlled Graves disease presents with temperature 40.1 C, HR 168, BP 162/96, agitation,…

Question

A client with poorly controlled Graves disease presents with temperature 40.1 C, HR 168, BP 162/96, agitation, and new atrial fibrillation. Which interventions should the nurse anticipate as priority? Select all that apply.

Accepted Answer

Thyroid storm management: beta-blocker (propranolol/esmolol) for sympathetic crisis, antithyroid drug (PTU preferred in pregnancy and storm because it also blocks T4-to-T3 conversion; methimazole otherwise), iodine to block hormone release given AT LEAST 1 HOUR after antithyroid drug (otherwise iodine would be substrate), glucocorticoids (hydrocortisone 100 mg q8h) for adrenal stress and conversion blockade, active cooling, and treat precipitant (infection, surgery). ASPIRIN is CONTRAINDICATED — it displaces thyroid hormone from thyroid binding globulin worsening storm. Acetaminophen is the antipyretic of choice.

A client with poorly controlled Graves disease presents with temperature 40.1 C, HR 168, BP 162/96, agitation, and new atrial fibrillation. Which interventions should the nurse anticipate as priority? Select all that apply.

Select All That Apply

Master the NCLEX-RN with MyMerci

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A client with poorly controlled Graves disease presents with temperature 40.1 C, HR 168, BP 162/96, agitation, and new atrial fibrillation. Which interventions should the nurse anticipate as priority? Select all that apply.

Select All That Apply

Master the NCLEX-RN with MyMerci