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Regulatory: Thyroid Storm - Coggle Diagram
Regulatory: Thyroid Storm
Pathophysiology/Etiology
Etiology: Grave's disease
Hyperthyroidism from overstimulation of thyroid tissue, due to external factors (i.e. Grave's disease)
A trigger (i.e. infection) stimulates additional secretion of T3 and T4 hormones into the blood stream within a short period of time
Elevated TH causes body to enter hypermetabolic state - increased energy requirements and oxygen consumption
Catecholamines are released in response to stress while TH increases adrenergic receptor sensitivity
Stimulation of sympathetic nervous system causes increased HR and BP
Tachycardia and increased oxygen demands puts patient at risk for arrhythmias, heart failure, and death
Risk Factors
Diabetic ketoacidosis
Treatment noncompliance
Surgery and anesthesia
Symptoms
Hypermetabolic state
Febrile (>104 F)
Tachycardia (>130 bpm)
Heat intolerance, diaphoresis
Hypertension
Tremor
Lab/Diagnostic
Serum TH blood levels
High T3 and T4, low TSH
CBC count
Leukocytosis (elevated WBC)
Elevated LFTs from hypermetabolism
Radioactive iodine uptake and thyroid scan
Collaborative Treatment
Maintain a comfortable and cool environment for the patient
Utilize ice packs, hypothermic mattresses and blankets
Pharmacological interventions
PTU - block TH conversion
Iodine - block TH release
Methimazole - block TH synthesis
Beta Blocker - reduce HR
Acetaminophen - reduce fever
Administer humified oxygen to maintain O2 saturation and meet oxygen needs
Complications
Seizures and coma
Arrhythmia, atrial fibrillation
Heart failure