Answers
ACTIVE LEARNING TEMPLATE:
THYROID STORM:
Alterations in Health (Diagnosis):
- Examination of thyroid signs and symptoms
- Evaluation of T3 and T4 levels.
- Low TSH level.
Patho related to the problem:
Untreated hyperthyroidism leads to overproduction of hormones T3 and T4 level. A large amount of thyroid hormone results in thyroid storm.
Health promotion and disease prevention:
- Maintain thyroid level by following the therapy.
- Treatment of underlying cause.
- Exercise
- Reduction of stress.
- Adequate diet intake.
Risk factors:
- Autoimmune diseases
- Thyroid Nodules
- Consuming too much iodine.
- Patient with untreated hyperthyroidism.
Expected findings:
- Lag of eye movement
- thinning of hair
- goiter
- bruit
- dyspnea
- tachycardia
Safety:
- Caution should be taken in treating pregnant women.
- The older adult can develop atrial fibrillation so precautions should be followed.
Laboratory test:
- T3
- T4
- TSH Level
- Thyroid stimulating immunoglobulins
- Antibodies of the thyrotropin receptor
Diagnostic procedure:
- ECG
- USG
- Radioactive iodine uptake.
Nursing care:
- Assist in daily activities and minimizes energy expenditure.
- Monitor nutritional status.
- Monitor daily weight.
- Provide comfort environment.
- Administer medications regularly.
Therapeutic procedures:
Radioiodine uptake test or surgical removal of the thyroid gland is the therapeutic procedure to treat the thyroid storm.
Medications:
- Beta-blocker
- Potassium iodide
- Glucocorticoid
- Propylthiouracil
Client Education:
- Assess for the iodine allergy.
- Radioactive iodine should be taken prior to 24hrs.
- Educate about protein-rich diet.
Interprofessional care:
- Radiotherapist should instruct the patient before and after the procedure.
- The physician should examine the patient before the surgery.
- The nurse should monitor the client before and after the procedure.
Complication:
- Atrial fibrillation
- Osteoporosis
- Heart failure