Total Thyroidectomy

Paramedics bring a 66-year-old woman to the ED. Her blood pressure is 104/58 mmHg, pulse rate 44 beats/minute, respiratory rate 14 breaths/minute, and temperature 92.4o F (33.6oC). No medical history is available, except for the patient’s statement of not feeling well for the past month. Physical examination reveals a lethargic, thin woman with dry skin and periorbital and facial edema. Bilateral pulmonary congestion is noted. EKG monitoring shows sinus bradycardia. The physician diagnoses impending myxedema coma. The patient remains hypothermic, with a temperature of 95o F (35oC). The nurse would anticipate the treatment for this patient to include all of the following except:

A 55-year-old woman is admitted to the ED with a temperature of 105o F (40.5oC), blood pressure 180/110 mmHg, pulse rate 120 beats/minute, and respiratory rate 36 breaths/minute. She shows signs of dehydration and states that she has been experiencing muscle weakness and bone pain for the past week. She has a history of Grave’s disease. The physician diagnoses thyroid crisis. Which nursing measure would be inappropriate in controlling a patient’s pyrexia that is in thyroid crisis?

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of:

The nurse would assess for hyperkalemia by observing for which EKG change:

Which nursing action is not a priority during the initial management of a patient with HHNK?

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of:

Which electrolyte imbalance would the nurse expect a patient to have in myxedema coma?

A 55-year-old woman is admitted to the ED with a temperature of 105o F (40.5oC), blood pressure 180/110 mmHg, pulse rate 120 beats/minute, and respiratory rate 36 breaths/minute. She shows signs of dehydration and states that she has been experiencing muscle weakness and bone pain for the past week. She has a history of Grave’s disease. The physician diagnoses thyroid crisis. The nurse would assess this patient for signs of:

Paramedics bring a 66-year-old woman to the ED. Her blood pressure is 104/58 mmHg, pulse rate 44 beats/minute, respiratory rate 14 breaths/minute, and temperature 92.4o F (33.6oC). No medical history is available, except for the patient’s statement of not feeling well for the past month. Physical examination reveals a lethargic, thin woman with dry skin and periorbital and facial edema. Bilateral pulmonary congestion is noted. EKG monitoring shows sinus bradycardia. The physician diagnoses impending myxedema coma. The patient remains hypothermic, with a temperature of 95o F (35oC). An appropriate nursing intervention would be to:

A 65-year-old woman is brought to the ED by ambulance after fainting. Physical examination reveals central-type obesity with a fatty buffalo hump in the neck, hirsutism, thin and fragile extremities with ecchymotic areas, hypertension, and mild congestive heart failure. She informs the nurse that she has experienced extreme weakness and fatigue during the past month and that her sleep patterns have become altered. The nurse realizes that the patient’s signs and symptoms are characteristic of: