An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of:
a- Thyroid storm.
b- Cretinism.
c- myxedema coma.
d- Hashimoto’s thyroiditis.
Answer C.
Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema.
Thyroid storm is an acute complication of hyperthyroidism.
Cretinism is a form of hypothyroidism that occurs in infants.
Hashimoto’s thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.
Coma is a severe lack of thyroid hormones, leading to change in the patient's mental state, low temperature and other symptoms.
Considered coma myxedema one emergency medical cases that have a high degree of risk, as they may sometimes cause death if they are processed quickly and correctly.
Symptoms of mucous edema:
Lazy laziness patients often feel laziness and inactivity, weight gain, dryness of the skin, severe constipation. These symptoms become more severe and the patient feels depressed, psychotic, and may reach the symptoms of hallucinations and loss of consciousness (coma).
These symptoms are accompanied by a decrease in body temperature, weakness and slow heartbeat, swollen hands, feet and around the eyes, slow breathing rate, fluid gathering around the lungs, ascites (fluid pooling in the abdominal cavity), convulsions and, as previously mentioned, coma.
Reasons:
The most prominent cause is the severe lack of thyroid hormones untreated, or the removal of the thyroid gland or treatment of thyroid activity by radioactive iodine. This defect may also result from the following causes:
- Severe infections in the body.
- Severe burns.
- Low body temperature and exposure to extreme cold.
- Heart clot or heart muscle dysfunction.
- An imbalance in the salts of the body either high sugar or low sugar substance in the body, or increase acidity of the body due to slow breathing process.
Some drugs, such as opioid analgesics, drugs, some heart medications such as beta inhibitors, and drugs that treat arrhythmias such as amiodarone and some antibiotics such as rifampicin, neuropathy drugs such as fentinine.
How to Diagnose:
The coma is often diagnosed through the patient's history, either pre-diagnosed with thyroid dysfunction, preoperative thyroid surgery or iodine therapy, as well as symptoms that preceded this condition.
However, this condition must be confirmed by laboratory tests and some radiations, which may appear:
- A severe lack of thyroid hormone and a high rise in the hormone stimulating the secretion of the thyroid gland.
- Low sodium or sugar, and high creatinine (one of the kidney functions) in the blood.
- The rise of white blood cells resulting from inflammation in the body may be leading to this coma.
- X-rays may show some signs of fluid gathering around the lungs and heart, and some signs of myocardial failure.
- Histological drawing of the heart.
How to treat:
As we mentioned earlier, this condition is very urgent, which must be treated immediately after clinical diagnosis, even before the results of the laboratory. The mortality rate in these cases ranges between 30-40% if treated properly and strictly!
The patient needs to be hypnotized in intensive care to monitor his heart condition and artificial respiration through devices. The patient is given a high dose of thyroxine (thyroid hormone in both inactive and active) through the vein and cortisone.
As for the symptoms associated with the low temperature is treated by heating the body gradually. Disorders of the salts of the body are treated by intravenous solutions, and if inflammation is the cause of this condition, it is treated by intravenous antibiotics.
After the patient is fully cured and the patient is discharged from the hospital, the patient should follow the condition of the thyroid gland by re-analyzing the functions of the thyroid gland during the period of 4-6 weeks, through which the appropriate dose is calculated for the patient.
a- Thyroid storm.
b- Cretinism.
c- myxedema coma.
d- Hashimoto’s thyroiditis.
Answer C.
Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema.
Thyroid storm is an acute complication of hyperthyroidism.
Cretinism is a form of hypothyroidism that occurs in infants.
Hashimoto’s thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.
Coma is a severe lack of thyroid hormones, leading to change in the patient's mental state, low temperature and other symptoms.
Considered coma myxedema one emergency medical cases that have a high degree of risk, as they may sometimes cause death if they are processed quickly and correctly.
Symptoms of mucous edema:
Lazy laziness patients often feel laziness and inactivity, weight gain, dryness of the skin, severe constipation. These symptoms become more severe and the patient feels depressed, psychotic, and may reach the symptoms of hallucinations and loss of consciousness (coma).
These symptoms are accompanied by a decrease in body temperature, weakness and slow heartbeat, swollen hands, feet and around the eyes, slow breathing rate, fluid gathering around the lungs, ascites (fluid pooling in the abdominal cavity), convulsions and, as previously mentioned, coma.
Reasons:
The most prominent cause is the severe lack of thyroid hormones untreated, or the removal of the thyroid gland or treatment of thyroid activity by radioactive iodine. This defect may also result from the following causes:
- Severe infections in the body.
- Severe burns.
- Low body temperature and exposure to extreme cold.
- Heart clot or heart muscle dysfunction.
- An imbalance in the salts of the body either high sugar or low sugar substance in the body, or increase acidity of the body due to slow breathing process.
Some drugs, such as opioid analgesics, drugs, some heart medications such as beta inhibitors, and drugs that treat arrhythmias such as amiodarone and some antibiotics such as rifampicin, neuropathy drugs such as fentinine.
How to Diagnose:
The coma is often diagnosed through the patient's history, either pre-diagnosed with thyroid dysfunction, preoperative thyroid surgery or iodine therapy, as well as symptoms that preceded this condition.
However, this condition must be confirmed by laboratory tests and some radiations, which may appear:
- A severe lack of thyroid hormone and a high rise in the hormone stimulating the secretion of the thyroid gland.
- Low sodium or sugar, and high creatinine (one of the kidney functions) in the blood.
- The rise of white blood cells resulting from inflammation in the body may be leading to this coma.
- X-rays may show some signs of fluid gathering around the lungs and heart, and some signs of myocardial failure.
- Histological drawing of the heart.
How to treat:
As we mentioned earlier, this condition is very urgent, which must be treated immediately after clinical diagnosis, even before the results of the laboratory. The mortality rate in these cases ranges between 30-40% if treated properly and strictly!
The patient needs to be hypnotized in intensive care to monitor his heart condition and artificial respiration through devices. The patient is given a high dose of thyroxine (thyroid hormone in both inactive and active) through the vein and cortisone.
As for the symptoms associated with the low temperature is treated by heating the body gradually. Disorders of the salts of the body are treated by intravenous solutions, and if inflammation is the cause of this condition, it is treated by intravenous antibiotics.
After the patient is fully cured and the patient is discharged from the hospital, the patient should follow the condition of the thyroid gland by re-analyzing the functions of the thyroid gland during the period of 4-6 weeks, through which the appropriate dose is calculated for the patient.
Labels
Endocrine Disorders