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Clinical Manifestations

A. Cardiovascular Manifestations:

1. Tachycardia: Severe, persistent, and often refractory to treatment.

2. Hypertension: High blood pressure resulting from increased cardiac output and peripheral vascular resistance.

3. Arrhythmias: Atrial fibrillation and other dysrhythmias are common and may lead to cardiac decompensation.

 

B. Central Nervous System (CNS) Manifestations:

1. Agitation and Delirium: Patients may exhibit extreme restlessness, confusion, or altered mental status.

2. Seizures: In severe cases, seizures may occur due to the hyperexcitable state of the CNS.

3. Coma: In untreated or advanced stages, thyroid storm can progress to a coma.

C. Gastrointestinal Manifestations:

1. Nausea and Vomiting: Patients may experience severe gastrointestinal symptoms.

2. Diarrhea: Frequent and watery bowel movements due to increased gut motility.

D. Hyperthermia: 

Profound fever, often exceeding 40°C (104°F), due to increased metabolic rate and impaired thermoregulation.

E. Respiratory Manifestations:

1. Dyspnea: Rapid, shallow breathing and increased respiratory rate.

2. Respiratory Failure: In severe cases, respiratory failure may occur due to increased oxygen demand and metabolic acidosis.

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Questions on Clinical Manifestations

Correct Answer is C

Explanation

<p>This choice is correct. Reporting signs of infection or illness is important to ensure timely medical attention and prevent potential exacerbation of hyperthyroidism or thyroid storm.</p>

Correct Answer is B

Explanation

<p>Encouraging high-sodium foods is not a priority intervention in thyroid storm and may exacerbate fluid and electrolyte imbalances.</p>

Correct Answer is A

Explanation

No explanation

Correct Answer is B

Explanation

<p>Thyroid peroxidase antibody (TPOAb) test detects the presence of thyroid autoantibodies and is used to diagnose autoimmune thyroid conditions.</p>

Correct Answer is D

Explanation

<p>Minimizing external stimuli and noise helps reduce stress and anxiety for the client with thyroid storm and promotes a calm and safe environment.</p>

Correct Answer is B

Explanation

<p>Hypocalcemia is not a typical electrolyte imbalance in thyroid storm.</p>

Correct Answer is B

Explanation

No explanation

Correct Answer is C

Explanation

<p>Oxygen saturation is important for assessing respiratory status but may not directly reflect thyroid storm severity or treatment response.</p>

Correct Answer is B

Explanation

<p>Encouraging warm baths is contraindicated in thyroid storm, as it can exacerbate hyperthermia. Cold measures are preferred.</p>

Correct Answer is D

Explanation

<p>After radioactive iodine therapy, it may take several weeks for thyroid hormone levels to normalize. Continuing antithyroid medication during this period helps prevent exacerbation of hyperthyroidism and potential thyroid storm.</p>

Correct Answer is B

Explanation

<p>Decreased respiratory rate is not a typical manifestation of thyroid storm, as clients often experience rapid breathing due to the hypermetabolic state.</p>

Correct Answer is C

Explanation

<p>Digoxin (Lanoxin) is used to treat heart failure and is not typically used to manage symptoms in thyroid storm.</p>

Correct Answer is C

Explanation

<p>This choice is incorrect. Decreased appetite is not a priority assessment finding in thyroid storm. More significant symptoms such as agitation and tachycardia take precedence.</p>

Correct Answer is D

Explanation

<p>Thyroid storm is characterized by an increased metabolic rate, leading to hyperglycemia. The increased metabolic demand and stress response can result in elevated blood glucose levels.<br /> <br /> </p>

Correct Answer is C

Explanation

No explanation

Correct Answer is B

Explanation

No explanation

Correct Answer is D

Explanation

<p>Exophthalmos (protruding eyeballs) is a characteristic finding in thyroid storm due to increased sympathetic activity and inflammation of the orbital tissues.</p>

Correct Answer is B

Explanation

<p>Liothyronine (Cytomel) is a thyroid hormone replacement medication and is contraindicated in the treatment of thyroid storm, as it would worsen the hyperthyroid state.</p>

Correct Answer is C

Explanation

<p>This choice is incorrect. Weight loss, rather than weight gain, is a characteristic feature of hyperthyroidism, including thyroid storm.</p>

Correct Answer is D

Explanation

<p>Potassium iodide is administered to block the release of thyroid hormones and manage thyroid storm. It helps restore normal heart rhythm and reduce cardiac manifestations.</p>

Correct Answer is C

Explanation

No explanation

Correct Answer is D

Explanation

<p>Administering beta-blockers is a priority intervention in thyroid storm to reduce heart rate and control sympathetic nervous system effects. Thyroid storm is characterized by severe tachycardia and increased sympathetic activity.</p>

Correct Answer is D

Explanation

<p>The thyroid peroxidase antibody (TPOAb) test is used to detect the presence of antibodies against thyroid peroxidase, an enzyme involved in thyroid hormone production. Elevated TPOAb levels indicate autoimmune thyroid conditions, which can contribute to thyroid storm.</p>

Correct Answer is D

Explanation

<p>Sodium polystyrene sulfonate (Kayexalate) is used to bind excess thyroid hormones and temporarily reduce their release. It is part of the medical management of thyroid storm to manage severe hyperthyroidism.</p>

Correct Answer is A

Explanation

<p>Encouraging physical activity is contraindicated in thyroid storm, as it can exacerbate symptoms and increase the risk of complications.</p>

No explanation

No explanation

<p>Diarrhea, not constipation, is a common gastrointestinal symptom associated with thyroid storm. Increased metabolic rate in thyroid storm can lead to diarrhea.</p>

<p>Increasing intake of iodized salt can exacerbate hyperthyroidism and increase the risk of thyroid storm. Clients with hyperthyroidism are often advised to reduce iodine intake.</p>

No explanation

<p>This choice is correct. While seafood is a source of iodine, consuming excessive amounts can exacerbate hyperthyroidism and increase the risk of thyroid storm. Moderate iodine intake is recommended.</p>

No explanation

<p>This choice is correct. Notifying the healthcare provider about palpitations or rapid heartbeat is important to address potential worsening of hyperthyroidism and prevent thyroid storm.</p>

<p>This choice is incorrect. Stress reduction helps manage hyperthyroidism and prevent thyroid storm but does not necessarily &quot;normalize&quot; thyroid hormone levels.</p>

No explanation

<p>This choice is incorrect. Calcium gluconate may be administered to address the potential risk of hypocalcemia associated with thyroid storm, but it is not typically administered as a first-line priority medication.</p>

<p>Skipping doses can disrupt the effectiveness of medication therapy and worsen the client&#39;s condition.</p>

<p>Excessive thyroid hormone levels in thyroid storm lead to hypermetabolism, which results in increased oxygen consumption, heat production, and energy expenditure. This hypermetabolic state is associated with symptoms such as tachycardia, hypertension, fever, and profuse sweating.</p>

No explanation

No explanation

<p>Bacterial infections are not a common trigger for thyroid storm.</p>

No explanation

No explanation

<p>Administering intravenous potassium supplements is not a standard intervention for thyroid storm. Electrolyte imbalances may occur, but potassium replacement should be based on laboratory values.</p>

No explanation

No explanation

<p>This choice is incorrect. Muscle weakness is a symptom of hyperthyroidism but is not an immediate concern that requires urgent intervention.</p>

<p>Administering sedatives can mask the client&#39;s true condition and may not be appropriate for a client in thyroid storm.</p>

<p>Measuring thyroid hormone levels, specifically triiodothyronine (T3) and thyroxine (T4), is an essential diagnostic evaluation for thyroid storm. Elevated levels of these hormones indicate excessive thyroid hormone production and are indicative of thyroid storm.</p>

<p>This choice is incorrect. Normal TSH levels would not be seen in thyroid storm, as TSH would be suppressed due to elevated thyroid hormone levels.</p>
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