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Terms in this set (6)
A life-threatening condition that occurs when hypothyroidism is untreated or when a stressor such as infection affects an individual with hypothyroidism
Myxedema coma S/S
Significantly decreased respirations, so PaCO2 levels may rise
Worsening cerebral hypoxia
Nursing Responses to Myxedema Coma
Maintain airway patency with ventilary support if necessary
Maintain circulation through IV fluid replacement
Provide continuous EKG monitoring
Monitor ABGs to detect hypoxia and metabolic acidosis
Warm the client with blankets
Monitor body temperature until stable
Replace thyroid hormone by administering large IV levothryoxine (Synthroid) doses, as ordered. Monitor VS because rapid correction of hypothyroidism can cause adverse cardiac effects
Monitor I&O and daily weight. With treatment, urine output should increase and body weight decrease; if not, report to the provider.
Replace fluids and other substances, such as glucose, as needed
Administer corticosteroids, as ordered
Check for possible sources of infections such as blood, sputum or urine-which may have precipitated coma. Treat underlying illness.
Because older adult clients with hypothyroidism may have confusing signs and symptoms that mimic the aging process, hypothyroidism is often undiagnosed in older adult clients, which can lead to potentially serious s/e from medications such as sedatives, opiates, and anesthetics
Older adults-thyroid hormone replacement
When starting thyroid hormone replacement, care must be taken with older adult clients and with those who have coronary artery disease to avoid cardiac ischemia because of increased oxygen demands of the heart. It is preferable to start with much lower doses and increase gradually, taking 1-2 months to reach full replacement doses.
Polypharmacy is a significant concern for the hypothyroid client. Several classifications of meds. are affected by the addition of thryoid supplements, including beta-blockers, oral anticoagulants, bronchodilators, digitalis preparations, TCAs, and cholesterol0lowering agents.
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