Page 1393 - Saunders Comprehensive Review For NCLEX-RN

thyroidectomy if prescribed.
l. Elevate the head of the bed of a client
experiencing exophthalmos; in
addition, instruct on low-salt diet,
administer artificial tears, encourage
the use of dark glasses, and tape
eyelids closed at night if necessary.
m. Allow the client to express concerns
about body image changes.
D. Thyroid storm
1. Description (Box 46-11)

2. Assessment

a. Elevated temperature (fever)
b. Tachycardia
c. Systolic hypertension
d. Nausea, vomiting, and diarrhea
e. Agitation, tremors, anxiety
f. Irritability, agitation, restlessness,
confusion, and seizures as the
condition progresses
g. Delirium and coma

3. Interventions

a. Maintain a patent airway and adequate
ventilation.
b. Administer antithyroid medications,
iodides, propranolol, and
glucocorticoids as prescribed.
c. Monitor vital signs.
d. Monitor continually for cardiac
dysrhythmias.
e. Administer nonsalicylate antipyretics as
prescribed (salicylates increase free
thyroid hormone levels).
f. Use a cooling blanket to decrease
temperature as prescribed.
E. Thyroidectomy
1. Description
a. Removal of the thyroid gland
b. Performed when persistent
hyperthyroidism exists
c. Subtotal thyroidectomy, removal of a
portion of the thyroid gland, is the
preferred surgical intervention.
2. Preoperative interventions
a. Obtain vital signs and weight.

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