Page 346 - Critical Care Nursing Demystified

Chapter 7 CARE OF THE PATIENT WITH ENDOCRINE DISORDERS 331

6 Nursing Diagnosis for Thyroid Storm Expected Outcomes
Disturbed metabolic state related Body temperature will return to normal
to hyperthermia and loss of body reading of 98.6°F
temperature regulation Patientʼs metabolic rate will reveal a
return to euthyroid status

Nursing Interventions
Hourly monitoring of body temperature to determine return to normal range.
Assess fluid status by monitoring hourly intake and output.
Assess hydration level by examining skin turgor, mucous membranes, and
extremes of diaphoresis.
Determine patient’s level of tolerance to variations in environmental tem-
peratures, for example, too hot, throwing off clothes, demanding window
opening.
Provide comfort measures to patient by offering more room ventilation, fan
and window opening, cold fluids, and lighter clothing.
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Provide cooling blanket to bring body temperature back to normal.
Assess daily weights to evaluate changes in body mass and nutritional status.

Administer antithyroid medications as prescribed.
Evaluate diagnostic laboratory results for thyroid, glucose, and electrolyte
status.
Teach coping strategies in an effort to calm and decrease patient’s emotional
irritability.

1 Parathyroid Gland

The parathyroid gland consists of four small, oval-shaped glands arranged in
pairs and located close to and behind the thyroid gland. The parathyroid gland
is responsible for the production and release of parathormone (PTH). Functions
of PTH are as follows:
1. Works in partnership with vitamin D to stimulate calcium and phospho-
rous absorption from the intestinal mucosa.
2. Promotes bone strength and movement of calcium from the bone. Ninety-
nine percent of calcium is found in the bones and 1% is found in the blood-
stream. Normal calcium value is 9.0 to 11.0 mg/dL or 4.5 to 5.5 mEq/L.