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Regulatory: Thyroid Storm - Coggle Diagram
Regulatory: Thyroid Storm
Pathophysiology
An exacerbation of hyperthyroidism triggered by an insult (infection, DKA, thyroid damage, stress, stopping meds) causes a surge in T3 and T4 - leading to a hypermetabolic state
The SNS activation stimulates the TSH cascade increasing T3 & T4
O2 and ATP cunsumption is increases - hypermetabolism
Trigger causes a fight or flight response by releasing catecholamines
Symptoms of hypermetabolism ensue: hot, diaphoretic, HTN, palpations...
Symptoms
Fever
CV effects
Tachycardia
Congestive failue
Angina
HTN
CNS effects
Restless
Agitation
Delirium
Tremors
Dyspnea
vomiting
Diaphoresis
Risk Factors
Stress
Infection
Thyroidectomy
Uncontrolled hyperthyroidism
Diabetes
Digitalis toxicity
Pregnancy
Lab/Diagnostics
Blood work (
Thyroid hormones
, WBC, Glucose, Cortisol)
Collaborative treatment
Admin Thionamides
Admin sodium iodide as Rx 1 hr after thionamids
Cool blanket, sponge bath, or ice packs to lower body temp
Admin glucosteroids for adrenal insufficiency or shock
Admin IV fluid and monitor I/O
Restore F/E balance
Reduce cardiac demand - admin beta blocker
Complications
cardiac collapse
coma
Fluid loss
pulm embolism
death