REVIEW WITH EXPLANATORY ANSWERS
◉ Nursing management for the top 3 priority concerns of an SIADH
pt. Answer: *Fluid volume excess*
---> Monitoring dec fluid load
---> Promote a dec to normal fluid volume
*High risk for altered renal tissue perfusion*
---> Monitor serum Na levels
---> Monitor for changes in LOC
---> Promote inc to normal Na levels
*Monitoring, managing, & preventing life-threatening emergencies*
---> Seizures & encephalopathy
◉ Grave's disease. Answer: Common cause of hyperthyroidism
---> Overproduction of T3 & T4, low TSH
D/t autoimmune disease, unknown causes, or thyroid stimulating
antibodies
,◉ S&S of Grave's Disease (hyperthyroidism). Answer: • Warm moist
skin, flushing
• Inc perspiration
• Fine, thin hair
• Fingernails separate from nail beds (Plummer nails)
• Tachypnea, dyspnea
• Weight loss
• N/V
• Nervousness, restlessness
• Tremors of eyelids/hands
• Staring gaze/exophthalmos
• Widened pulse pressure
**COMPLICATION: Hyperthyroid crisis (thyroid storm)***
◉ A patient with hyperthyroidism begins to get restless. Their HR is
190 and their BP is 200/90. The nurse identifies this as what & thus
gives what medication?. Answer: Hyperthyroid crisis/thyroid storm
Give beta blocker
◉ Hyperthyroidism's effects on body. Answer: • Inc metabolic rate
,• Inc heat production
---> These pt have heat intolerance
---> Nurses can help by giving anti-pyretics (acetaminophen)
• Inc CHO & Fat metabolism
• Inc HR & CO
• Inc RR & depth of RR
• Hyperactive DTRs
• Inc appetite
• Emotional instability
◉ S&S of thyroid storm. Answer: DEATH CAN OCCUR
---> Nurses should monitor for this
• Temp > 102-106º
, • Severe tachycardia, palpations >140 bpm
• Aggravation of angina
• Dyspnea
• Psychotic behavior
• Extreme irritability
• Extreme diaphoresis
• Severe HTN
◉ Medications for hyperthyroidism/Grave's Disease. Answer: •
*Beta blockers*
---> Inderal (propanolol)
---> Metoprolol
---> Low HR/BP
• Glucocorticoids
---> Dexamethasone